Active NPI
Richard Lee Sorensen, PHD
- Psychologist
- St Petersburg, FL
National Provider Identifier
1861501538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY4438
- Practice address
- 111 2ND Ave NE
Suite 908
St Petersburg, FL 33701 - Phone
- (727) 438-4237
- Fax
- (727) 982-2454
- NPI assigned
- Aug 29, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY4438 | FL | Primary |
| Psychologist | 103T00000X | 0773 | NM | |
| Psychologist | 103T00000X | 2906 | CO |
Addresses
Primary practice location
111 2ND Ave NE
Suite 908
St Petersburg, FL 33701
Mailing address
111 2ND Ave NE
Suite 908
St Petersburg, FL 33701
Phone (727) 438-4237
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY4438 | FL | MD | Psychologist |
| 0773 | NM | MD | Psychologist |
| 2906 | CO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861501538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 2ND AVE NE",
"address_2": "SUITE 908",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "33701",
"telephone_number": "727-438-4237",
"fax_number": "727-982-2454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 2ND AVE NE",
"address_2": "SUITE 908",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "33701",
"telephone_number": "727-438-4237",
"fax_number": "727-982-2454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORENSEN",
"first_name": "RICHARD",
"middle_name": "LEE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "FL",
"license": "PY4438",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NM",
"license": "0773",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "2906",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.