Healthcare Provider Details

I. General information

NPI: 1598629362
Provider Name (Legal Business Name): SONDERMIND PROFESSIONAL CLINICAL COUNSELOR, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6203 SAN IGNACIO AVE STE 110
SAN JOSE CA
95119-1358
US

IV. Provider business mailing address

1099 18TH ST STE 2350
DENVER CO
80202-1936
US

V. Phone/Fax

Practice location:
  • Phone: 844-843-7279
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: CARMEN FELDMAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 303-960-3889