Provider Demographics
NPI:1578189908
Name:SOMMERS-SOUDER, BETH ANN (MSW, LISW-S)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:SOMMERS-SOUDER
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RICHLAND CORRECTIONAL INSTITUTE
Mailing Address - Street 2:1001 OLIVESBURG ROAD
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905
Mailing Address - Country:US
Mailing Address - Phone:419-526-2100
Mailing Address - Fax:
Practice Address - Street 1:RICHLAND CORRECTIONAL INSTITUTE
Practice Address - Street 2:1001 OLIVESBURG ROAD
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905
Practice Address - Country:US
Practice Address - Phone:419-526-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0500005-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical