| Doctor Name: | MARK J SADERHOLM |
| NPI Number: | 1265567549 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPCC |
| License Number: | 1097 |
| Business Practice Address: | 112 Sartin Dr. Edmonton, KY - 42129 |
| Business Phone Number: | 2704324951 |
| Business Fax Number: | 2704325054 |
| Mailing Address: | 833 Franklin Rd, SUMMER SHADE |
| State: | KY |
| Postal Code: | 421669730 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/23/2007 |
| NPI Last Update Date: | 07/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1097 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |