Molly Rose Soberalski, LMHCA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

88002181A Issued in IN

Practice address

4150 Illinois Rd
Fort Wayne, IN 46804-1208

Phone

(877) 594-9204

NPI assigned

Mar 25, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1922858521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468024004",
            "telephone_number": "260-710-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 ILLINOIS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041208",
            "telephone_number": "877-594-9204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468024004",
            "country_code": "US",
            "telephone_number": "260-710-0216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOBERALSKI",
        "first_name": "MOLLY",
        "middle_name": "ROSE",
        "credential": "LMHCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "88002181A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Snyder, PHARMD
• Peter Benson C So, MD
• Soaring Mind, Inc. (MindCAP Services)
• David Michael Sober, BCBA
• Matthew Soberalski
• Angela M Sobieck, NP
• Audrey Fawn Sofair, MD
• Sofia Home Care LLC
• Sofia Home Health Care LLC
• Syed Sohail, M.D.MPH.MBA

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.