Provider Demographics
NPI:1376740670
Name:SORENSEN, MARIA (MA, LCDP, SAP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:MA, LCDP, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 OLD BAPTIST RD
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-3647
Mailing Address - Country:US
Mailing Address - Phone:401-932-8620
Mailing Address - Fax:
Practice Address - Street 1:1180 OLD BAPTIST RD
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-3647
Practice Address - Country:US
Practice Address - Phone:401-932-8620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI00271101YA0400X
101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool