Virginia Sorenson, LP LMFT

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP1355 Issued in MN

Practice address

411 Birchwood Ave
White Bear Lake, MN 55110-1802

Phone

(612) 385-1156

NPI assigned

Sep 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Virginia Jacobs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Bhsi, LLC

  • Clinical Psychologist
  • North Saint Paul, MN
  • NPI 1174635643

  Clinical

  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1851497879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 BIRCHWOOD AVE",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551101802",
            "telephone_number": "612-385-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 BIRCHWOOD AVE",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551101802",
            "telephone_number": "612-385-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "VIRGINIA",
        "credential": "LP LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP1355",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "680",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "702678100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIRGINIA",
            "last_name": "JACOBS",
            "credential": "LP, LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tabitha Soderstrom, MS
• Soleck Ventures Inc
• John Solomon, LPC
• Abigail Solorzano
• Sonder Grove Therapy, LLC
• Gissel Sosa
• Soul Chiropractic
• Linnea Kay Soular, DC
• Brady Sowers
• Patrick G Spencer, FNP-C

• All providers in White Bear Lake, MN
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.