MEDICARE: SOMATIC AGENCY LLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1750218061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOMATIC AGENCY LLC

Provider Business Mailing Address
First Line	:	3357 36TH AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2130
Country	:	US
Telephone Number	:	612-465-9685
Fax Number	:

Provider Business Practice Location Address
First Line	:	3357 36TH AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2130
Country	:	US
Telephone Number	:	612-465-9685
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	GALEN DAVID
Credential	:	LPCC
Telephone Number	:	612-465-9685

Provider Enumeration Date	:	05/08/2026
Last Update Date	:	05/08/2026

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Directions to “SOMATIC AGENCY LLC ” Practice Location

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