Active NPI
Mary Jo Sorensen, MS, LMFT
- Marriage & Family Therapist
- Chippewa Falls, WI
National Provider Identifier
1154484020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 709-124
- Practice address
- 2661 County Highway I
Chippewa Falls, WI 54729-5407 - Phone
- (715) 723-5585
- NPI assigned
- Dec 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 709-124 | WI | Primary |
Addresses
Primary practice location
2661 County Highway I
Chippewa Falls, WI 54729-5407
Mailing address
2661 County Highway I
Chippewa Falls, WI 54729-5407
Phone (715) 723-5585
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41006500 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 709-124 | WI | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189728000000",
"number": "1154484020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2661 COUNTY HIGHWAY I",
"city": "CHIPPEWA FALLS",
"state": "WI",
"postal_code": "547295407",
"telephone_number": "715-723-5585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2661 COUNTY HIGHWAY I",
"city": "CHIPPEWA FALLS",
"state": "WI",
"postal_code": "547295407",
"telephone_number": "715-723-5585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORENSEN",
"first_name": "MARY JO",
"credential": "MS, LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2007-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WI",
"license": "709-124",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41006500",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chippewa Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.