Individual provider Active NPI

Lisa Sorensen, PH.D.

  • Clinical Neuropsychologist
  • Arlington Heights, IL
National Provider Identifier
1497809768
Registry record updated Jul 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
071006192 Issued in IL
Practice address
855 E Golf Rd Ste 2139
Arlington Heights, IL 60005-5225
Phone
(847) 357-9158
NPI assigned
Jan 23, 2007
Last updated
Jul 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071-006192 IL
Clinical Neuropsychologist 103G00000X 071006192 IL Primary

Addresses

Primary practice location

855 E Golf Rd Ste 2139
Arlington Heights, IL 60005-5225

Mailing address

855 E Golf Rd Ste 2139
Arlington Heights, IL 60005-5225
Phone (847) 357-9158

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071006192ILMDClinical Neuropsychologist
071-006192ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Denise a Fiducia, PHD & Associates, LLC Clinical Neuropsychologist CurrentSince Jul 28, 2019 Accepting new patients
Axiscare Neuropsychology, LLC Clinical Neuropsychologist PastSince Jul 28, 2019 Accepting new patients

Locations

855 E Golf Rd
Ste 2139
Arlington Hts, IL 60005
Phone (847) 357-9158

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1497809768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 E GOLF RD STE 2139",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600055225",
            "telephone_number": "847-357-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 E GOLF RD STE 2139",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600055225",
            "telephone_number": "847-357-9158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071-006192",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071006192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.