Active NPI
Christine Marie Soderman
- Professional Counselor
- Mahwah, NJ
National Provider Identifier
1851895841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 37AC00410300
- Practice address
- 860 Wyckoff Ave
Mahwah, NJ 07430-3186 - Phone
- (201) 485-7172
- NPI assigned
- Mar 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 37AC00410300 | NJ | Primary |
Addresses
Primary practice location
860 Wyckoff Ave
Mahwah, NJ 07430-3186
Mailing address
320 Georgian Dr
Paramus, NJ 07652-4219
Phone (201) 421-6943
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37AC00410300 | NJ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521676800000",
"number": "1851895841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 GEORGIAN DR",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076524219",
"telephone_number": "201-421-6943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 WYCKOFF AVE",
"city": "MAHWAH",
"state": "NJ",
"postal_code": "074303186",
"telephone_number": "201-485-7172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SODERMAN",
"first_name": "CHRISTINE",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-22",
"last_updated": "2018-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NJ",
"license": "37AC00410300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mahwah, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.