# SOLACE GROVE PSYCHOTHERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497629695
- **Authorized official:** DR. JACOB ALEXANDER MOORE PH.D. (FOUNDER/PSYCHOLOGIST)
- **Authorized official phone:** (301) 272-5080

## Contact information

- **Practice address:** 6325 WOODSIDE CT, COLUMBIA, MD 21046-1017
- **Practice address phone:** (410) 886-6202
- **Mailing address:** 6325 WOODSIDE CT, COLUMBIA, MD 21046-1017
- **Mailing address phone:** (410) 886-6202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 10/01/2025
- **Last updated:** 10/01/2025