Provider Demographics
NPI:1295170579
Name:SOROKA, LAURA J (MSW,BA,LCSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:SOROKA
Suffix:
Gender:F
Credentials:MSW,BA,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINISTRATION
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 1:141 E MAIN ST
Practice Address - Street 2:WATERBURY CLINICAL SERVICES 2ND FLOOR
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2310
Practice Address - Country:US
Practice Address - Phone:203-723-9599
Practice Address - Fax:203-723-9890
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT90191041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CT060669107OtherUBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CTPENDINGOtherMHN NETWORK MANAGE HEALTH NETWORK
CT008060712Medicaid
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CT13671709OtherCAQH
CTD339225-PINE STOtherVALUE OPTIONS
CTPENDINGOtherMHN TRICARENORTH
CT060669107OtherUBH-CONNECTICARE
CT060669107OtherUNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CT060669107OtherUBH-OXFORD HEALTH/FREEDOM/LIBERTY WELLMORE GRP/FACILITY
CTD339225-PINE STOtherVALUE OPTIONS