Caitlyn Brianne Sorensen-Kowalski, PHD, LP, BCBA-LBA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301018402 Issued in MI

Practice address

18471 Haggerty Rd
Northville, MI 48168-8513

Phone

(248) 735-5928

NPI assigned

Feb 26, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Caitlyn Brianne Sorensen Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589846400000",
    "number": "1245570308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 HILLSIDE CT",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481972138",
            "telephone_number": "586-453-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18471 HAGGERTY RD",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481688513",
            "telephone_number": "248-735-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN-KOWALSKI",
        "first_name": "CAITLYN",
        "middle_name": "BRIANNE",
        "name_prefix": "Dr.",
        "credential": "PHD, LP, BCBA-LBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-26",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "1-13-13053",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAITLYN",
            "last_name": "SORENSEN",
            "middle_name": "BRIANNE",
            "credential": "PHD, LP, BCBA-LBA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Psychologist in Northville, MI
• Providers in Northville, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2020; 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.