Provider Demographics
NPI:1912379009
Name:SORENSEN, JILL (MA)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 ACOMA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-1429
Mailing Address - Country:US
Mailing Address - Phone:303-800-5024
Mailing Address - Fax:303-777-7601
Practice Address - Street 1:121 ACOMA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-1429
Practice Address - Country:US
Practice Address - Phone:303-800-5024
Practice Address - Fax:303-777-7601
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor