Provider Demographics
NPI:1588700066
Name:SODERBERG, MONICA (LSCSW)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:
Last Name:SODERBERG
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 KENTUCKY ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2823
Mailing Address - Country:US
Mailing Address - Phone:785-841-5555
Mailing Address - Fax:785-841-8781
Practice Address - Street 1:901 KENTUCKY ST
Practice Address - Street 2:SUITE 301
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2823
Practice Address - Country:US
Practice Address - Phone:785-841-5555
Practice Address - Fax:785-841-8781
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0986174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist