Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CAPTAIN BLAKE SODERSTROM
Active Sole ProprietorCAPTAIN BLAKE SODERSTROM is a Mental Health Counselor healthcare provider located in BRIMLEY, Michigan. NPI 1699176677 is currently active in the NPPES registry. Verify at CMS.
Mental Health Counselor · BRIMLEY, MI
Registration Details
- NPI Number
- 1699176677
- Provider Type
- Individual
- Gender
- Unknown
- NPI Issued
- Sep 10, 2014 (11.917615542839 yrs)
- Last Updated
- Apr 5, 2024
- Licenses
-
6401222931 (MI)010908-01 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
PO BOX 303BRIMLEY, MI, 497150303Browse MI providers · Browse ZIP 49715
- Phone
- 9062038354
- Primary Specialty
-
Mental Health Counselor
101YM0800X
- Additional Specialty
- Mental Health Counselor
Other Mental Health Counselor Providers in BRIMLEY, MI
| Name | Credential | NPI |
|---|---|---|
| KATHRYN LUDLOW | — | 1083264121 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.