| Captain Blake Soderstrom, | |
|
Po Box 303, Brimley, MI 49715-0303 | |
| (906) 203-8354 | |
| Not Available |
| Full Name | Captain Blake Soderstrom |
|---|---|
| Gender | |
| Speciality | Counselor - Mental Health |
| Location | Po Box 303, Brimley, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699176677 | NPI | - | NPPES |
| 03505424 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6401222931 (Michigan) | Secondary |
| 101YM0800X | Counselor - Mental Health | 010908-01 (New York) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Captain Blake Soderstrom, Po Box 303, Brimley, MI 49715-0303 Ph: (906) 203-8354 | Captain Blake Soderstrom, Po Box 303, Brimley, MI 49715-0303 Ph: (906) 203-8354 |
Kathryn Ludlow, Counselor Medicare: Not Enrolled in Medicare Practice Location: 7134 S M 221, Brimley, MI 49715 Phone: 906-248-3219 | |
Julie Anne Mckelvie, SW Counselor Medicare: Not Enrolled in Medicare Practice Location: 12124 W Lakeshore Dr, Brimley, MI 49715 Phone: 906-248-5527 Fax: 906-248-5765 | |
Ms. Brett Elizabeth Carr, Counselor Medicare: Not Enrolled in Medicare Practice Location: 12124 West Lakeshore Drive, Brimley, MI 49715 Phone: 906-248-8322 Fax: 906-248-8322 | |
Renee A Johnson, LMSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 12124 W Lakeshore Dr, Brimley, MI 49715 Phone: 906-248-5527 Fax: 906-248-5765 | |
Mrs. Tara Lynn Tremblay, Counselor Medicare: Not Enrolled in Medicare Practice Location: 12124 W Lakeshore Dr, Brimley, MI 49715 Phone: 906-248-8352 Fax: 906-248-3508 |