Active NPI
Nicole Sorensen, MS, BCBA
- Behavior Analyst
- Shorewood, WI
National Provider Identifier
1689052268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 11417264
- Practice address
- 4545 N Sheffield Ave
Shorewood, WI 53211-1309 - Phone
- (414) 299-0045
- NPI assigned
- May 14, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 11417264 | OH | Primary |
Addresses
Primary practice location
4545 N Sheffield Ave
Shorewood, WI 53211-1309
Mailing address
4545 N Sheffield Ave
Shorewood, WI 53211-1309
Phone (414) 299-0045
Other practice location 1
4051 Afton Elklick Rd
Batavia, OH 45103-9407
Phone (859) 446-1200
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11417264 | OH | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537315200000",
"number": "1689052268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4545 N SHEFFIELD AVE",
"city": "SHOREWOOD",
"state": "WI",
"postal_code": "532111309",
"telephone_number": "414-299-0045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4545 N SHEFFIELD AVE",
"city": "SHOREWOOD",
"state": "WI",
"postal_code": "532111309",
"telephone_number": "414-299-0045"
}
],
"practiceLocations": [
{
"address_1": "4051 Afton Elklick Rd",
"address_purpose": "LOCATION",
"city": "Batavia",
"state": "OH",
"postal_code": "451039407",
"country_code": "US",
"telephone_number": "859-446-1200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SORENSEN",
"first_name": "NICOLE",
"credential": "MS, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-14",
"last_updated": "2018-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "OH",
"license": "11417264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shorewood, WI
- Shorewood Health Department
- Shorewood School District
- Shorewood Specialty LLC (Sage Specialty Pharmacy)
- Andrew M Silverman, LCSW
- Sunae Son, L.AC
- Anne Marie Sprenger, RD
- Sprout Behavioral Health Services LLC
- Standard of Care Counseling and Consultation Service LLC
- Chloe Staub, CCC-SLP
- Stein Optical Inc (Stein Optical)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.