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CAPTAIN BLAKE SODERSTROM
NPI 1699176677
Counselor - Mental Health in Brimley, MI

Active since September 10, 2014

NPPES record last updated: April 5, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Apr 5, 2024, Mar 30, 2016 (2 updates tracked since 2016).

About Captain Blake Soderstrom NPPES

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

CAPTAIN BLAKE SODERSTROM (NPI 1699176677) is an individual mental health provider in Brimley, Michigan, licensed in New York (010908-01) and active in the NPI registry since September 2014.

NPPES Registry Identity

NPI1699176677
Entity TypeIndividual
Primary Taxonomy101YM0800X
Provider Legal NameCAPTAIN BLAKE SODERSTROM
Location AddressPO BOX 303Brimley, MI 49715-0303
Mailing AddressPo Box 303Brimley, MI 49715-0303 · (906) 203-8354
Phone(906) 203-8354
Sole ProprietorYes
Enumeration DateSeptember 10, 2014
Last NPPES UpdateApril 5, 20242 updates tracked since enumeration
NPPES CertifiedApril 5, 2024
✔ NPI 1699176677 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Licenses✔ Licensed in NY · 010908-01✔ Licensed in MI · 6401222931
PO BOX 303, Brimley, MI 49715
Open in Google Maps ↗

Other Identifiers 1

Medicaid03505424NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross Blue Shield of Michigan Mutual Insurance Company, UnitedHealthcare.Insurance ›

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 Captain Soderstrom's NPI number?

The NPI number for Captain Soderstrom is 1699176677. It was assigned to this individual provider in the NPPES registry on September 10, 2014.

Where is Captain Soderstrom located?

Captain Soderstrom practices at PO Box 303, Brimley, MI 49715. The listed phone number is (906) 203-8354.

What is Captain Soderstrom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

What insurance does Captain Soderstrom accept?

Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company and UnitedHealthcare list Captain Soderstrom as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Captain Soderstrom was last updated on April 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.