Provider Demographics
NPI:1427382068
Name:SORENSON, KIRSTEN L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KIRSTEN
Middle Name:L
Last Name:SORENSON
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINSTRATION
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:30 PECK RD
Practice Address - Street 2:BUILDING 2 SUITE 2203
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790
Practice Address - Country:US
Practice Address - Phone:860-626-7007
Practice Address - Fax:860-626-7014
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2018-05-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT91841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060669107OtherUBH-CONNECTICARE WELLMORE GRP/FACILITY
CTNOT ELIGIBLEOtherMHN MANAGE HEALTH NETWORK
CTNOT ELIGIBLEOtherMHN TRICARE NORTH
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CT008054818OtherHP MEDICAID
CT060669107OtherUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
CT13540650OtherCAQH
CT060669107OtherANTHEM BCBS OF CT
CT060669107OtherUBH-OXFORD LIBERTY/FREEDOM HEALTH WELLMORE GRP/FACILITY
CT060669107OtherUNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
CTD339230-TORRINGTONOtherVALUE OPTIONS
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CT060669107OtherUNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY