MACKENZIE SODESTROM MA
NPI 1356864854
Marriage & Family Therapist in Oakland, CA

Q: What is Mackenzie Sodestrom's NPI number?

The NPI number for Mackenzie Sodestrom is 1356864854. It was assigned to this individual provider in the NPPES registry on July 17, 2017.

Q: What is Mackenzie Sodestrom's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: Is Mackenzie Sodestrom enrolled in Medicare?

No. Mackenzie Sodestrom has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since July 17, 2017Opted out of Medicare · through Jan 1, 2028

287 17TH ST STE 205, OAKLAND, CA 94612(510) 210-1191 Get Directions Write a Review

NPPES record last updated: August 26, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 26, 2019, Jul 17, 2017 (2 updates tracked since 2017).

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About Mackenzie Sodestrom Ma NPPES

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

MACKENZIE SODESTROM MA (NPI 1356864854) is an individual marriage & family therapist in Oakland, California and active in the NPI registry since July 2017. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1356864854

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMACKENZIE SODESTROMCredential: MA

Location Address287 17TH ST STE 205Oakland, CA 94612

Mailing Address287 17th St Ste 205Oakland, CA 94612-4116 · (510) 210-1191

Phone(510) 210-1191

Sole ProprietorYes

Enumeration DateJuly 17, 2017

Last NPPES UpdateAugust 26, 20192 updates tracked since enumeration

✔ NPI 1356864854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

287 17TH ST STE 205, Oakland, CA 94612

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Mackenzie Sodestrom Ma has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

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 Mackenzie Sodestrom's NPI number?

The NPI number for Mackenzie Sodestrom is 1356864854. It was assigned to this individual provider in the NPPES registry on July 17, 2017.

Where is Mackenzie Sodestrom located?

Mackenzie Sodestrom practices at 287 17th St Ste 205, Oakland, CA 94612. The listed phone number is (510) 210-1191.

What is Mackenzie Sodestrom's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Mackenzie Sodestrom enrolled in Medicare?

No. Mackenzie Sodestrom has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Mackenzie Sodestrom was last updated on August 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.