Provider Demographics
NPI:1891778833
Name:SODEN, CATHERINE L (LCPC, CADC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:L
Last Name:SODEN
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:DOVER FOXCROFT
Mailing Address - State:ME
Mailing Address - Zip Code:04426-1270
Mailing Address - Country:US
Mailing Address - Phone:207-564-4410
Mailing Address - Fax:207-564-4478
Practice Address - Street 1:69 HIGH ST
Practice Address - Street 2:
Practice Address - City:DOVER FOXCROFT
Practice Address - State:ME
Practice Address - Zip Code:04426-1270
Practice Address - Country:US
Practice Address - Phone:207-564-4110
Practice Address - Fax:207-564-4478
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2010-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME#CAC4421101YA0400X
ME#CC3239101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431837599Medicaid