Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Captain Blake Soderstrom

Individual provider Mental Health Counselor · NPI 1699176677

Captain Blake Soderstrom is a Mental Health Counselor in Brimley, Michigan. Practices as a sole proprietor. Licensed in Michigan and New York.

Licensed in
MI, NY
In the registry since
2014
Specialties on file
2
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Practice location PO Box

The provider listed a PO Box rather than a street location, so this is not a walk-in address.

PO Box 303
Brimley, MI 49715-0303
Phone: (906) 203-8354
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 010908-01 (NY)
Mental Health Counselor Taxonomy 101YM0800X · Licence 6401222931 (MI)

Record details

NPI number1699176677
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorYes
NPI enumeratedSeptember 10, 2014
Last updated in NPPESApril 5, 2024
Certification dateApril 5, 2024
Mailing addressPo Box 303, Brimley, MI 49715-0303

Other providers in Brimley