Sonia Jo Bly, MS, DC
Individual provider Active NPI Professional Counselor · Marshall, MN
NPI 1245242536 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1245242536
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 00275 (MN)
- Practice address
- 1212 E College Dr
Marshall, MN 56258-2010 - Phone
- (507) 532-3236
- Fax
- (507) 532-0240
- NPI assigned
- Aug 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Western Mental Health Center, Inc.
Practice addresses (Care Compare)
1212 E College Dr
Marshall, MN 56258-2010
Phone (507) 532-3236
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240211000066 | MN | Practitioner - Mental Health Counselor | 2860835436 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00275 | MN | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Mental Health Center, Inc. | Current |
Accepting new patients |
Locations
818 Prentice St
Granite Falls, MN 56241
Phone (320) 564-2238
1212 E College Dr
Marshall, MN 56258
Phone (507) 532-3236
3001 Maple Rd
Slayton, MN 56172
Phone (507) 836-6144
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/wmhcinc/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 00275 | MN | Yes |
Addresses
Primary practice location
1212 E College Dr
Marshall, MN 56258-2010
Mailing address
205 Prairieview CT
Marshall, MN 56258-5486
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 613K4BL | Other | MN | BLUE CROSS BLUE SHIELD |
| 49412 | Other | MN | SIOUX VALLEY HEALTH |
| 988631045917 | Other | MN | PREFERRED ONE |
| HP58525 | Other | MN | HEALTH PARTNERS |
Other names
- Miss Sonia Jo Jimenez
Other providers in Marshall, MN
- Nancy J Blanchard
- Christina Blomme
- Courtney June Blomme
- Kristin R Blomme
- Martha Alicia Blomme
- Theresa Rose Bly
- Brian David Boersma
- Riley May Boese
- Kylie Linden Bossuyt
- Julijana Botic
All providers in Marshall, MN · Professional Counselor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.