Provider Demographics
NPI:1902249667
Name:SOLTIS, LEVI GREGORY (LMSW)
Entity Type:Individual
Prefix:MR
First Name:LEVI
Middle Name:GREGORY
Last Name:SOLTIS
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MI
Mailing Address - Zip Code:49262-9754
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MI
Practice Address - Zip Code:49262-9754
Practice Address - Country:US
Practice Address - Phone:517-212-4052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-12
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801092017104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801092017OtherSTATE OF MICHIGAN