Provider Demographics
NPI:1639315245
Name:SONDEL, EMILIE BLOCH (LPC)
Entity Type:Individual
Prefix:
First Name:EMILIE
Middle Name:BLOCH
Last Name:SONDEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-2935
Mailing Address - Country:US
Mailing Address - Phone:608-255-7356
Mailing Address - Fax:608-255-0457
Practice Address - Street 1:831 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-2935
Practice Address - Country:US
Practice Address - Phone:608-255-7356
Practice Address - Fax:608-255-0457
Is Sole Proprietor?:No
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4012-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42145300Medicaid