Provider Demographics
NPI:1871949537
Name:SODERLING, MARIAH (SAC)
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:
Last Name:SODERLING
Suffix:
Gender:F
Credentials:SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JUNEAU COUNTY DEPT OF HUMAN SERVICES
Mailing Address - Street 2:200 HICKORY ST
Mailing Address - City:MAUSTON
Mailing Address - State:WI
Mailing Address - Zip Code:53948
Mailing Address - Country:US
Mailing Address - Phone:608-847-2400
Mailing Address - Fax:608-847-9421
Practice Address - Street 1:JUNEAU COUNTY DEPT OF HUMAN SERVICES
Practice Address - Street 2:200 HICKORY ST
Practice Address - City:MAUSTON
Practice Address - State:WI
Practice Address - Zip Code:53948
Practice Address - Country:US
Practice Address - Phone:608-847-2400
Practice Address - Fax:608-847-9421
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16398-131101YA0400X
171M00000X
WI17902-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator