MEDICARE: AMELIA SOHLER LMHC, SUDP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CP60541114	WA
2	101YM0800X	Mental Health Counselor	LH60642587	WA

General Provider Information

NPI Number	:	1154770188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMELIA SOHLER LMHC, SUDP

Provider Business Mailing Address
First Line	:	111 TUMWATER BLVD SE STE 210
Second Line	:
City	:	TUMWATER
State	:	WA
Zip	:	98501-6400
Country	:	US
Telephone Number	:	360-791-7479
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 TUMWATER BLVD SE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98501-6400
Country	:	US
Telephone Number	:	360-791-7479
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2016
Last Update Date	:	12/14/2021

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