Provider Demographics
NPI:1598053241
Name:SORENSON, JANAE J (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JANAE
Middle Name:J
Last Name:SORENSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 W 1400 N
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-6813
Mailing Address - Country:US
Mailing Address - Phone:435-752-8880
Mailing Address - Fax:435-752-8884
Practice Address - Street 1:380 W 1400 N
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-6813
Practice Address - Country:US
Practice Address - Phone:435-752-8880
Practice Address - Fax:435-752-8884
Is Sole Proprietor?:No
Enumeration Date:2011-07-15
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT275975-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical