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Active NPI 1144368010 Individual Practitioner Male Practitioner

Randy K Soderquist , LCSW

Social Worker - Clinical • Fredonia, AZ

Professional Overview & Biography Verified Profile Summary

Randy Soderquist, LCSW is a registered healthcare professional specializing in Social Worker - Clinical in Fredonia, AZ. Practice services are available at 465 SOUTH MAIN under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

465 South Main

Fredonia, AZ 86022

Telephone 9286436000
Associated Practice Facility / Clinic
🏢 Tearace Ent., Llc Facility NPI 1326504523

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker - Clinical in Fredonia, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.4 Yrs
Regional Practice Density
3 Specialists

Practicing in Fredonia, AZ (3316 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Social Worker - Clinical Primary Specialty

NUCC Taxonomy Code: 1041C0700X

State License UT 131852-3501

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Social Worker - Clinical

NUCC Taxonomy Code: 1041C0700X

State License AZ LCSW-12612

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID State License
131852-3501 (UT)
Commercial Insurance / Payer ID State
LCSW-12612 (AZ)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 12, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location October 12, 2012

Registered at 465 SOUTH MAIN, FREDONIA, AZ 86022 (Tel: 9286436000)

📍
Updated Business Mailing Address October 12, 2012

Registered at 465 SOUTH MAIN, P.O. BOX 710, FREDONIA, AZ 86022 (Tel: 9286436000)

👤
Provider Name / Credentials Updated October 12, 2012

Recorded as RANDY SODERQUIST, LCSW

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 12, 2012

Social Worker (License #131852-3501 in UT)

🟢
Initial NPI Registration & Enumeration February 02, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1144368010
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 02, 2007
Last Update: October 12, 2012
Sole Proprietor: No

Mailing Address

465 South Main, P.o. Box 710

Fredonia, AZ 86022

Phone: 9286436000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.