Mark Saderholm, LPCC

Individual provider Mental Health Counselor · NPI 1265567549

Mark Saderholm, LPCC is a Mental Health Counselor in Edmonton, Kentucky. Qualified in 2004, 22 years ago. Works from 2 locations. Licensed in Kentucky.

Years since qualifying: 22
Licensed in: KY
In the registry since: 2007
Specialties on file: 2

What do these letters mean?

LPCC — Licensed Professional Clinical Counselor: The title some states use for a licensed clinical counsellor.

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Practice location Address checks out

112 Sartin Dr
Edmonton, KY 42129
Phone: (270) 432-4951
Fax: (270) 432-5054

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

200 N Crawford St, Tompkinsville, KY 42167-1678 — (270) 901-5000

Specialties & licences

Professional Counselor (primary)	Taxonomy 101YP2500X · Licence 102948 (KY)
Mental Health Counselor	Taxonomy 101YM0800X

Record details

NPI number	1265567549
Entity type	Individual (Type 1)
Gender	Male
Credentials	LPCC
Sole proprietor	No
NPI enumerated	February 23, 2007
Last updated in NPPES	October 3, 2024
Certification date	October 3, 2024
Mailing address	380 Suwannee Trail St, Bowling Green, KY 42103-7956

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialty	MENTAL HEALTH COUNSELOR
Medical school	OTHER
Graduated	2004 (22 years in practice)
Accepts Medicare assignment	Not indicated
Practice locations	3 on file with Medicare