MRS. GREETA MAE SODERHOLM LICSW LADC NPI 1609381094

NPI Information

NPI: 1609381094
Provider Name: MRS. GREETA MAE SODERHOLM, LICSW, LADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

PECOS Registration: Yes

Address:
76 GLEN RD
BURLINGTON, VT
ZIP 05401
Phone: (802) 864-7467
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MRS. Greeta Mae Soderholm, LICSW, LADC is an addiction (substance use disorder) counselor in Burlington, VT. MRS. Greeta Mae Soderholm, LICSW, LADC NPI is 1609381094. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

76 GLEN RD
BURLINGTON, VT
ZIP 05401-131
Phone: (802) 864-7467
Fax: (802) 864-1619

The NPI 1609381094 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 12/6/2017 and was last updated on 12/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	151.0125896	VERMONT	Yes
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)		VERMONT	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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