Individual provider Active NPI

Elizabeth Sharon Sorenson, LICSW

  • Clinical Social Worker
  • Duluth, MN
National Provider Identifier
1225708936
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24038 Issued in MN
Practice address
1509 E Superior St Apt 203
Duluth, MN 55812-4402
Phone
(218) 451-1041
NPI assigned
Sep 14, 2021
Last updated
Sep 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 24038 MN Primary

Addresses

Primary practice location

1509 E Superior St Apt 203
Duluth, MN 55812-4402

Mailing address

819 E 5TH St Apt 2
Duluth, MN 55805-3142
Phone (218) 451-1041

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address biz@harvestmoonmhservices.com Health Information Exchange (HIE)

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
24038MNMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1225708936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 E 5TH ST APT 2",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558053142",
            "telephone_number": "218-451-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 E SUPERIOR ST APT 203",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558124402",
            "telephone_number": "218-451-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "ELIZABETH",
        "middle_name": "SHARON",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "biz@harvestmoonmhservices.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1509 E Superior St Apt 203",
            "city": "Duluth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "558124402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.