Provider Demographics
NPI:1982831202
Name:SORENSEN, AUSTIN L (MSW)
Entity Type:Individual
Prefix:
First Name:AUSTIN
Middle Name:L
Last Name:SORENSEN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:NV
Mailing Address - Zip Code:89301-2407
Mailing Address - Country:US
Mailing Address - Phone:775-293-1558
Mailing Address - Fax:775-375-0813
Practice Address - Street 1:802 AVENUE E
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301-2423
Practice Address - Country:US
Practice Address - Phone:775-293-1558
Practice Address - Fax:775-375-0813
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6171-C104100000X
NVPENDING104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker