Provider Demographics
NPI:1144839275
Name:SOLOMON KOMADINA, SLOAN ELLE (LPC)
Entity type:Individual
Prefix:
First Name:SLOAN
Middle Name:ELLE
Last Name:SOLOMON KOMADINA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SLOAN
Other - Middle Name:
Other - Last Name:SOLOMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:9385 ANTERO ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-8128
Mailing Address - Country:US
Mailing Address - Phone:818-943-8209
Mailing Address - Fax:
Practice Address - Street 1:4704 HARLAN ST STE 200
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80212-7417
Practice Address - Country:US
Practice Address - Phone:970-919-0279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0015834101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty