Randy K Soderquist, LCSW is a
Social Worker - Clinical based in Fredonia, Arizona. Randy K Soderquist is licensed to practice in Utah (license number 131852-3501) and his current practice location is
465 South Main, Fredonia, Arizona. He can be reached at his office (for appointments etc.) via phone at
(928) 643-6000.
NPI number for Randy K Soderquist is 1144368010 and his current mailing address is 465 South Main, P.o. Box 710, Fredonia, Arizona. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1144368010.
Healthcare Provider's Profile
| Full Name | Randy K Soderquist |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
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| Location | 465 South Main, Fredonia, Arizona |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1144368010
- Provider Enumeration Date: 02/02/2007
- Last Update Date: 10/12/2012
Medical Identifiers
Medical identifiers for Randy K Soderquist such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144368010 | NPI | - | NPPES |
| 131852-3501 | Other | UT | STATE LICENSE |
| LCSW-12612 | Other | AZ | STATE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1041C0700X | Social Worker - Clinical | 131852-3501 (Utah) | Primary |
| 1041C0700X | Social Worker - Clinical | LCSW-12612 (Arizona) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Randy K Soderquist is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Randy K Soderquist, LCSW
465 South Main, P.o. Box 710,
Fredonia, AZ 86022
Ph: (928) 643-6000 | Randy K Soderquist, LCSW
465 South Main,
Fredonia, AZ 86022
Ph: (928) 643-6000 |
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