Provider Demographics
NPI:1851518906
Name:SORENSEN, RACHEL MICELE (LADC, LIMHP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:MICELE
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:LADC, LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2170 N PLATTE AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2630
Mailing Address - Country:US
Mailing Address - Phone:402-720-3992
Mailing Address - Fax:402-753-6445
Practice Address - Street 1:2170 N PLATTE AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2630
Practice Address - Country:US
Practice Address - Phone:402-720-3992
Practice Address - Fax:402-753-6445
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1777101YM0800X
NE794101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025880800Medicaid
NE10025115400Medicaid