Individual provider Active NPI

Trudy Marie Soole, LADAC, LMHC

  • Mental Health Counselor
  • Sioux City, IA
National Provider Identifier
1952539355
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
090142 Issued in IA
Practice address
310 S Floyd Blvd Ste 107
Sioux City, IA 51101-2322
Phone
(505) 604-9634
Fax
(866) 897-7106
NPI assigned
Jun 24, 2009
Last updated
Nov 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0092631 NM
Mental Health Counselor 101YM0800X 090142 IA Primary

Addresses

Primary practice location

310 S Floyd Blvd Ste 107
Sioux City, IA 51101-2322

Mailing address

PO Box 711
Sioux City, IA 51102-0711
Phone (505) 604-9634

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0092631NMMDAddiction (Substance Use Disorder) Counselor
090142IAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1952539355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511020711",
            "telephone_number": "505-604-9634",
            "fax_number": "866-897-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S FLOYD BLVD STE 107",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511012322",
            "telephone_number": "505-604-9634",
            "fax_number": "866-897-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOOLE",
        "first_name": "TRUDY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LADAC, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0092631",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "090142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.