KARL ROBERT SODERSTROM (NPI# 1942866009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942866009 |
| Entity Type | Individual |
| Full Name | KARL ROBERT SODERSTROM |
| Practice Address |
591 S Knik Goose Bay Rd Wasilla AK 99654-8062 |
| Mailing Address |
300 N Main St Wasilla AK 99654-7017 |
| Practice Telephone | 9073131333 |
| Practice Fax Number | 9073578781 |
| Mailing Telephone | 9073578784 |
| Mailing Fax Number | 9073578781 |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2020-02-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
591 S KNIK GOOSE BAY RD |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-8062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558806604 | Brandy Stevens | Counselor | 591 S Knik Goose Bay Rd, Wasilla, AK 99654-8062 | 2016-12-28 |
| 1912506098 | Christopher Johnson | Peer Specialist | 591 S Knik Goose Bay Rd, Wasilla, AK 99654-8062 | 2020-10-20 |
| 1003420183 | Brittany Lynne Russell | Peer Specialist | 591 S Knik Goose Bay Rd, Wasilla, AK 99654-8062 | 2020-09-04 |
| 1518578020 | Holly A Hoff | Counselor | 591 S Knik Goose Bay Rd, Wasilla, AK 99654-8062 | 2020-08-10 |
| 1508476268 | Kenneth Dwayne Neill | Peer Specialist | 591 S Knik Goose Bay Rd, Wasilla, AK 99654-8062 | 2020-08-06 |
| 1114544152 | Johnathan Skoog | Peer Specialist | 591 S Knik Goose Bay Rd, Wasilla, AK 99654-8062 | 2020-06-25 |
| 1427673425 | Hannah Rogers | Peer Specialist | 591 S Knik Goose Bay Rd, Wasilla, AK 99654-8062 | 2020-06-15 |
| 1114542677 | Anne Benson | Peer Specialist | 591 S Knik Goose Bay Rd, Wasilla, AK 99654-8062 | 2020-06-10 |
| 1942829460 | True North Recovery Inc. | Substance Abuse Rehabilitation Facility | 591 S Knik Goose Bay Rd, Wasilla, AK 99654-8062 | 2020-04-14 |
| 1912530197 | Sean Morton | Peer Specialist | 591 S Knik Goose Bay Rd, Wasilla, AK 99654-8062 | 2020-02-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1689239782 | Kristine Ione Bayne | Counselor | 2651 N. Thordore Dr, Wasilla, AK 99623 | 2019-05-03 |
| 1619531217 | Antiqua Lisha Libbey | Counselor | 4821 S Outrigger Dr., Wasilla, AK 99687 | 2019-04-29 |
| 1225691025 | Rebecca Browning | Counselor | 26731 W Point Mackenzie Rd, Wasilla, AK 99623-8709 | 2019-04-17 |
| 1659722114 | Community Medical Services Montana-private, LLC | Counselor | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654 | 2016-06-27 |
| 1891112488 | Paul Bossart | Counselor | 1810 S Redwing Cir, Wasilla, AK 99654-9744 | 2014-03-21 |
| 1124321989 | Douglas Edward Smith | Counselor | 5431 E Mayflower Ln, Suite 5, Wasilla, AK 99654-7891 | 2010-12-16 |
| 1407170269 | Clifton Young IIi | Counselor | 701 E Parks Hwy Ste 203, Wasilla, AK 99654-8162 | 2010-03-23 |
| 1225268832 | Olive Tree Counseling, Inc. | Counselor | 5730 E Pilgrim Court, Suite A, Wasilla, AK 99654 | 2009-07-16 |
| 1285872317 | Rae Ann Hendrickson | Counselor | 5730 E Pilgrim Ct, Suite A, Wasilla, AK 99654-7824 | 2009-01-28 |
| Find all providers in WASILLA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.