Jessie Freesia Sorvaag Marg, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26474 Issued in MN

Practice address

5255 Members Pkwy NW
Rochester, MN 55901-8381

Phone

(507) 218-3720

Fax

(507) 258-5503

NPI assigned

Mar 27, 2020

Last updated

Nov 11, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• St. Croix Psychiatric, LLC

  dba PrairieCare Medical Group

  • Psychiatry Physician
  • Woodbury, MN
  • NPI 1881849586

  Clinical

  Medicare reassignment NPD
• Prairiecare LLC

  dba PrairieCare

  • Psychiatric Hospital
  • Brooklyn Park, MN
  • NPI 1215182928

  Clinical

  NPD (past)

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1558999508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 ZANE AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431814",
            "telephone_number": "763-762-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 MEMBERS PKWY NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559018381",
            "telephone_number": "507-218-3720",
            "fax_number": "507-258-5503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORVAAG MARG",
        "first_name": "JESSIE",
        "middle_name": "FREESIA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Jane Sorgenfrie-Wacholz, M.S., LADC, LPCC
• Sarah R Soriano, PA
• Vera Sorin, MD
• Atsushi Sorita, M.D.
• Gina Joan Gilmour Sorsen
• Benjamin Joseph Sosin, MD
• Tarek Souaid, MD, MPH
• Randa Soubra, LICSW
• Dylan Shea Soukup, MD
• Natalie Soukup

• Clinical Social Worker in Rochester, MN
• Providers in Rochester, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.