SAMANTHA SORENSEN PSYD LP LLC


Address: 9289 Central Ave Ne, Suite 401, Blaine, MN 55434-3424
Phone: 7636145060

SAMANTHA SORENSEN PSYD LP LLC (NPI# 1326410721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326410721
Entity Type Organization
Organization Name SAMANTHA SORENSEN PSYD LP LLC
Practice Address 9289 Central Ave Ne
Suite 401
Blaine
MN 55434-3424
Mailing Address 12331 Lever St Ne
Blaine
MN 55449-6643
Practice Telephone 7636145060
Practice Fax Number 7636145060
Mailing Telephone 7633509032
Mailing Fax Number 7636145060
Enumeration Date 2015-10-24
Last Update Date 2015-10-24
Authorized Official Name SAMANTHA SORENSEN (LICENSED PSYCHOLOGIST/OWNER)
Authorized Official Telephone 7633509032
Authorized Official Credential PSY.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC1900X Psychologist
Specialization: Counseling
LP5556 MN Behavioral Health & Social Service Providers

Office Location

Street Address 9289 CENTRAL AVE NE
SUITE 401
City BLAINE
State MN
Zip Code 55434-3424

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Taxonomy Information

Taxonomy Code 103TC1900X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Counseling

Taxonomy Definition

Definition to come...

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Competitor

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City BLAINE
Zip Code 55434

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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