Provider Demographics
NPI:1770475998
Name:ORANGE GLOW PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:ORANGE GLOW PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GILLIOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-442-1755
Mailing Address - Street 1:187 BELLINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:BUSHKILL
Mailing Address - State:PA
Mailing Address - Zip Code:18324-7754
Mailing Address - Country:US
Mailing Address - Phone:570-442-1755
Mailing Address - Fax:
Practice Address - Street 1:187 BELLINGHAM DR
Practice Address - Street 2:
Practice Address - City:BUSHKILL
Practice Address - State:PA
Practice Address - Zip Code:18324-7754
Practice Address - Country:US
Practice Address - Phone:570-442-1755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty