Sylvia Susanne Sorn

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

519100 Issued in OR

Practice address

17420 Crownview Dr
Gladstone, OR 97027-1107

Phone

(503) 656-1204

NPI assigned

Oct 15, 2014

Last updated

Oct 15, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1528462801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17420 CROWNVIEW DR",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271107",
            "telephone_number": "503-656-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17420 CROWNVIEW DR",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271107",
            "telephone_number": "503-656-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORN",
        "first_name": "SYLVIA",
        "middle_name": "SUSANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "OR",
            "license": "519100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "519100",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Taylor Sloan, CSWA
• Morgan Sloan, FNP-C
• Diane Y. Smith
• Elizabeth Daffer Smith, PHD, LCSW
• Sarah Riley Smith
• Sovereign Medical Transport, LLC
• Jeffrey Spears I, M.A., LPC
• Stephanie Lynne Speidel, LPC
• Susan Marie Stanton, CADC II
• Jessica A Steinhebel, MT-BC

• Mental Illness Community Based Residential Treatment Facility in Gladstone, OR
• Providers in Gladstone, OR by specialty
• Mental Illness Community Based Residential Treatment Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.