Provider Demographics
NPI:1952539355
Name:SOOLE, TRUDY MARIE (LADAC, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:TRUDY
Middle Name:MARIE
Last Name:SOOLE
Suffix:
Gender:F
Credentials:LADAC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 711
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51102-0711
Mailing Address - Country:US
Mailing Address - Phone:505-604-9634
Mailing Address - Fax:866-897-7106
Practice Address - Street 1:310 S FLOYD BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51101-2322
Practice Address - Country:US
Practice Address - Phone:505-604-9634
Practice Address - Fax:866-897-7106
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-24
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0092631101YA0400X
IA090142101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)