NPIMap

Organization Active NPI

Samantha Sorensen PSYD LP LLC

  • Counseling Psychologist
  • Blaine, MN
National Provider Identifier
1326410721
Registry record updated Oct 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP5556 Issued in MN
Legal business name
SAMANTHA SORENSEN PSYD LP LLC
Practice address
9289 Central Ave NE
Suite 401
Blaine, MN 55434-3424
Phone
(763) 614-5060
Fax
(763) 614-5060
NPI assigned
Oct 24, 2015
Last updated
Oct 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2015

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

Authorized official

Name
Samantha Sorensen, PSY.D.NPI 1750625166
Title
Licensed Psychologist/Owner
Phone
(763) 350-9032

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X LP5556 MN Primary

Addresses

Primary practice location

9289 Central Ave NE
Suite 401
Blaine, MN 55434-3424

Mailing address

12331 Lever St NE
Blaine, MN 55449-6643
Phone (763) 350-9032

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1445644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445644800000",
    "number": "1326410721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12331 LEVER ST NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554496643",
            "telephone_number": "763-350-9032",
            "fax_number": "763-614-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9289 CENTRAL AVE NE",
            "address_2": "SUITE 401",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343424",
            "telephone_number": "763-614-5060",
            "fax_number": "763-614-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMANTHA SORENSEN PSYD LP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-24",
        "last_updated": "2015-10-24",
        "status": "A",
        "authorized_official_last_name": "SORENSEN",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "763-350-9032",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP5556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2015; 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.