Active NPI
Tracy Dennis Sorensen
- Counselor
- Logan, UT
National Provider Identifier
1710123211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 286011-6004
- Practice address
- 655 E 1300 N
Logan, UT 84341-2570 - Phone
- (435) 792-6491
- NPI assigned
- Jan 5, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 286011-6004 | UT | Primary |
Addresses
Primary practice location
655 E 1300 N
Logan, UT 84341-2570
Mailing address
655 E 1300 N
Logan, UT 84341-2570
Phone (435) 792-6491
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 286011-6004 | UT | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231113600000",
"number": "1710123211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "655 E 1300 N",
"city": "LOGAN",
"state": "UT",
"postal_code": "843412570",
"telephone_number": "435-792-6491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "655 E 1300 N",
"city": "LOGAN",
"state": "UT",
"postal_code": "843412570",
"telephone_number": "435-792-6491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORENSEN",
"first_name": "TRACY",
"middle_name": "DENNIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-05",
"last_updated": "2009-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "UT",
"license": "286011-6004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.