1. Home
  2. Directory
  3. Kentucky
  4. Edmonton
  5. Counselor
  6. NPI Profile

MARK SADERHOLM LPCC
NPI 1265567549
Counselor - Professional in Edmonton, KY

Active since February 23, 2007PECOS Enrolled
112 SARTIN DR., EDMONTON, KY 42129(270) 432-4951(270) 432-5054 Get Directions Write a Review

NPPES record last updated: October 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 3, 2024, Dec 19, 2017 (2 updates tracked since 2017).

About Mark Saderholm Lpcc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK SADERHOLM LPCC (NPI 1265567549) is an individual professional provider in Edmonton, Kentucky, licensed in Kentucky (102948) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS, maintains a secondary practice location in Tompkinsville, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1265567549
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameMARK SADERHOLMCredential: LPCC
Location Address112 SARTIN DR.Edmonton, KY 42129
Mailing Address380 Suwannee Trail StBowling Green, KY 42103-7956 · (270) 901-5000 · Fax (270) 842-5268
Phone(270) 432-4951
Fax(270) 432-5054
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateFebruary 23, 2007
Last NPPES UpdateOctober 3, 20242 updates tracked since enumeration
NPPES CertifiedOctober 3, 2024
✔ NPI 1265567549 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in KY · 102948
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
112 SARTIN DR., Edmonton, KY 42129
Open in Google Maps ↗

Secondary Practice Location 1

Location 1200 N Crawford StTompkinsville, KY 42167-1678 · Phone (270) 901-5000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark Saderholm Lpcc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID941650949
PECOS Enrollment IDI20240102003964
Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TONY RUTHERFORD CASE MANAGER
Case Manager/Care Coordinator
112 SARTIN DR.
EDMONTON, KY 42129
Metcalfe County (270) 432-4951
DELORIS FAY GARRETT CASE MANAGER
Case Manager/Care Coordinator
112 SARTIN DR.
EDMONTON, KY 42129
Metcalfe County (270) 432-4951
RITA MILBY LPCA
Counselor
112 SARTIN DR.
EDMONTON, KY 42129
Metcalfe County (270) 432-4951
TINA FROEDGE CASE MANAGER
Case Manager/Care Coordinator
112 SARTIN DR.
EDMONTON, KY 42129
Metcalfe County (270) 432-4951
GEORGETTA KINGREY CASE MANAGER
Case Manager/Care Coordinator
112 SARTIN DR.
EDMONTON, KY 42129
Metcalfe County (270) 432-4951
CHRISTEN MONTGOMERY CASE MANAGER
Case Manager/Care Coordinator
112 SARTIN DR.
EDMONTON, KY 42129
Metcalfe County (270) 432-4951

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Saderholm's NPI number?

The NPI number for Mark Saderholm is 1265567549. It was assigned to this individual provider in the NPPES registry on February 23, 2007.

Where is Mark Saderholm located?

Mark Saderholm practices at 112 Sartin Dr., Edmonton, KY 42129. The listed phone number is (270) 432-4951.

What is Mark Saderholm's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Mark Saderholm enrolled in Medicare?

Yes. Mark Saderholm is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mark Saderholm was last updated on October 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.