Healthcare Provider Details

I. General information

NPI: 1477466845
Provider Name (Legal Business Name): EDGE OF MIND COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2105 PROSPERITY DR APT 304
GRAHAM NC
27253-8949
US

IV. Provider business mailing address

2105 PROSPERITY DR APT 304
GRAHAM NC
27253-8949
US

V. Phone/Fax

Practice location:
  • Phone: 585-469-9667
  • Fax:
Mailing address:
  • Phone: 585-469-9667
  • 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: MICHAEL SONDERICKER
Title or Position: MANAGING MEMBER
Credential: LCMHC-A, LCAS-A
Phone: 585-469-9667