| Solace Behavioral Health, Llc | |
|
17222 Hospital Blvd Ste 120 Brooksville FL 34601-8906 | |
| (352) 678-5550 | |
| (352) 678-5551 |
| Full Name | Solace Behavioral Health, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 17222 Hospital Blvd Ste 120, Brooksville, Florida |
| Authorized Official Name and Position | Tanveer A. Chaudhry (PRESIDENT, CEO) |
| Authorized Official Contact | 3526785550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Solace Behavioral Health, Llc 4800 Rowan Rd New Port Richey FL 34653-5609 Ph: (727) 483-5912 | Solace Behavioral Health, Llc 17222 Hospital Blvd Ste 120 Brooksville FL 34601-8906 Ph: (352) 678-5550 |
| NPI Number | 1760732887 |
|---|---|
| Provider Enumeration Date | 09/17/2012 |
| Last Update Date | 06/26/2024 |
| Certification Date | 06/26/2024 |
| Medicare PECOS PAC ID | 1254584667 |
|---|---|
| Medicare Enrollment ID | O20130116000145 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760732887 | NPI | - | NPPES |
| DU2657 | Other | FL | MEDICARE RAIL ROAD |
| 010023100 | Medicaid | FL | |
| GW088A | Other | FL | MEDICARE |
| Provider Name | George Michael Northrup |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629006507 PECOS PAC ID: 0840277927 Enrollment ID: I20040707000178 |
| Provider Name | Charles A Barrios |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023232162 PECOS PAC ID: 4183685183 Enrollment ID: I20041022000788 |
| Provider Name | Shodhan A Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518975564 PECOS PAC ID: 2961468095 Enrollment ID: I20041209000539 |
| Provider Name | Sylvia R Leaman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407828783 PECOS PAC ID: 9739193772 Enrollment ID: I20060130000639 |
| Provider Name | Tanveer Chaudhry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932195823 PECOS PAC ID: 3375557937 Enrollment ID: I20060202000686 |
| Provider Name | Diana Mimms |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619963501 PECOS PAC ID: 7911092887 Enrollment ID: I20071008000159 |
| Provider Name | Alma Reif |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114902574 PECOS PAC ID: 1153456157 Enrollment ID: I20100316000657 |
| Provider Name | Colin Matthew Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477995512 PECOS PAC ID: 5294967972 Enrollment ID: I20140411000018 |
| Provider Name | Tamara R Merens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730504374 PECOS PAC ID: 7012234701 Enrollment ID: I20150317001782 |
| Provider Name | Troy T Pulas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407074263 PECOS PAC ID: 0749322998 Enrollment ID: I20150529002555 |
| Provider Name | Dorothy Lynne Harty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174171813 PECOS PAC ID: 7012340441 Enrollment ID: I20191125002848 |
| Provider Name | Holly Cholvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619265006 PECOS PAC ID: 9537577705 Enrollment ID: I20210428001503 |
| Provider Name | Jane K Montavon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669084513 PECOS PAC ID: 2769871813 Enrollment ID: I20211111002155 |
| Provider Name | Jennifer Malenda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639680580 PECOS PAC ID: 4385033026 Enrollment ID: I20211117003354 |
| Provider Name | Lisa Marie Wolf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578152526 PECOS PAC ID: 3476912833 Enrollment ID: I20230807003763 |
| Provider Name | Jillian Munson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184215527 PECOS PAC ID: 0840607552 Enrollment ID: I20231113003731 |
| Provider Name | Cynthia Leland Fonda |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770185209 PECOS PAC ID: 7810347408 Enrollment ID: I20231221004051 |
| Provider Name | Gil J Fernandez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144579129 PECOS PAC ID: 8325498694 Enrollment ID: I20231228002447 |
| Provider Name | Felicia Dawn Alphonse |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457795825 PECOS PAC ID: 3072964659 Enrollment ID: I20240108005137 |
| Provider Name | Carol Amanda Rao |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801640214 PECOS PAC ID: 2860833670 Enrollment ID: I20240510002121 |
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