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Organization

SODAWELLNESS

Active
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Organization

SODAWELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES SODA M.A, LPC, LAC (OWNER)
(303) 489-0420
Entity
Organization

Contact information

Practice address
174 MIDLAND AVE, BASALT, CO 81621-8911
(303) 489-0420
Mailing address
PO BOX 4767, BASALT, CO 81621-4767

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0000453
CO
101YP2500X
Professional Counselor
Primary
LPC.0012446
CO

Other

Enumeration date
04/04/2016
Last updated
04/04/2016
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