LARETTA MACHELLE SOLOMON (NPI# 1750994257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750994257 |
| Entity Type | Individual |
| Full Name | LARETTA MACHELLE SOLOMON |
| Practice Address |
17235 Logan Cave Rd Lot 3 Siloam Springs AR 72761-9223 |
| Practice Telephone | 9184139235 |
| Mailing Telephone | 9184139235 |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| Street Address |
17235 LOGAN CAVE RD LOT 3 |
| City | SILOAM SPRINGS |
| State | AR |
| Zip Code | 72761-9223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164032702 | Christopher Ray Rouse | Peer Specialist | 17235 Logan Cave Rd Lot 3, Siloam Springs, AR 72761-9223 | 2020-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285908 | Tripharma Inc. | Pharmacy | 310 N Progress Ave, Siloam Springs, AR 72761 | 2019-09-24 |
| 1861058547 | Oyenike Adigun-awonaike | Nurse Practitioner | 3271, Hwy 412, Siloam Springs, AR 72761 | 2019-05-17 |
| 1811551989 | Natasha Victoria Clayton | Registered Nurse | 3721 U.S. 412 Hwy, Siloam Springs, AR 72761 | 2019-04-24 |
| 1649750662 | David Raymond Jordan | Physical Therapy Assistant | 301 Glenwood Pl, Siloam Springs, AR 72761 | 2018-08-20 |
| 1689120222 | Wesley Phillip Horton | Speech-Language Pathologist | 501 W Elgin St, Siloam Springs, AR 72761 | 2016-09-01 |
| 1407216138 | Amy Bassarear | Social Worker | 1500 N Mount Olive St Ste 1, Siloam Springs, AR 72761 | 2016-02-23 |
| 1033584073 | Siloam Springs Clinic Company, LLC | Clinic/Center | 3721 East 412 Hwy, Suite B, Siloam Springs, AR 72761 | 2015-12-02 |
| 1801279575 | Rachel Fritsche Gordon | Physician Assistant | Northwest Health Urgent Care-siloam Springs, 3721 Us-412, Siloam Springs, AR 72761 | 2015-06-30 |
| 1508258021 | Lifebridge Ar Counseling | Counselor | 301 East Ashley St., Siloam Springs, AR 72761 | 2015-02-20 |
| 1902176472 | Meghan Daley | Occupational Therapist | 918 South Mt Olive, Siloam Springs, AR 72761 | 2011-12-30 |
| Find all providers in zip 72761 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164032702 | Christopher Ray Rouse | Peer Specialist | 17235 Logan Cave Rd Lot 3, Siloam Springs, AR 72761-9223 | 2020-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538709290 | Kyle Ryan Keith | Peer Specialist | 25 Murphy Dr, Bella Vista, AR 72715-6913 | 2020-01-10 |
| 1588160634 | Terri Lashun Butler | Peer Specialist | 15 Azalea Loop, Conway, AR 72032-8522 | 2018-04-05 |
| 1548652332 | Jonathan Green | Peer Specialist | 710 Terry Ave, Springdale, AR 72764-6804 | 2015-03-03 |
| 1053944504 | Lonnie Phillips | Peer Specialist | 1521 Merrill Dr, Little Rock, AR 72211-1821 | 2020-02-12 |
| 1679127450 | Donterries L Alexander | Peer Specialist | 2904 Arkansas Blvd, Texarkana, AR 71854-2536 | 2019-07-30 |
| 1437621018 | Gary Wade Carter | Peer Specialist | 615 W Grand Ave, Hot Springs, AR 71901-3927 | 2018-12-20 |
| 1588032684 | Michael William Jones | Peer Specialist | 1500 Dodson Ave, Fort Smith, AR 72901-5182 | 2015-09-04 |
| 1487993655 | Judy Weaver | Peer Specialist | 350 Salem Rd Ste 1, Conway, AR 72034 | 2013-02-08 |
| 1386898765 | Raymond Zachary Bates | Peer Specialist | 3111 S 70th St, Fort Smith, AR 72903-5017 | 2008-11-11 |
| City | SILOAM SPRINGS |
| Zip Code | 72761 |
Please comment or provide details below to improve the information on LARETTA MACHELLE SOLOMON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.