Individual provider Active NPI

Leif Holbrook Sorensen, LCSW

  • Clinical Social Worker
  • Saint Anthony, ID
National Provider Identifier
1992903561
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-27666 Issued in ID
Practice address
335 E Main St Ste 3
Saint Anthony, ID 83445-1546
Phone
(208) 356-4900
Fax
(208) 624-4030
NPI assigned
Jul 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-27666 ID Primary

Addresses

Primary practice location

335 E Main St Ste 3
Saint Anthony, ID 83445-1546

Mailing address

PO Box 18
Saint Anthony, ID 83445-0018
Phone (208) 356-4900

Other practice location 1

72 S 1st E Ste 103
Rexburg, ID 83440-1902
Phone (208) 356-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130521000022 ID Practitioner - Clinical Social Worker 9537307137 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upper Valley Community Health Services IncGroup PAC ID 4385725282, 31 clinicians

Practice addresses (Care Compare)

335 E Main St
Saint Anthony, ID 83445-1546
Phone (208) 356-4900

72 S 1St
Suite 101
Rexburg, ID 83440-1902
Phone (208) 356-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-27666IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Arcadia Mental Health Resources CurrentSince Apr 3, 2013 Accepting new patients
Upper Valley Community Health Services Inc Current Accepting new patients
Upper Valley Community Health Services Inc CurrentSince Feb 12, 2024 Accepting new patients
Upper Valley Community Health Services Inc Social Worker Past Accepting new patients
Upper Valley Community Health Services Inc Social Worker Past Accepting new patients

Locations

72 S 1st E
Ste 103
Rexburg, ID 83440

72 S 1st E
Ste 101
Rexburg, ID 83440

104 N Bridge St
Ste 121
Saint Anthony, ID 83445
Phone (208) 624-2006

335 E Main St
Ste 3
Saint Anthony, ID 83445
Phone (208) 624-4100

335 E Main St
Saint Anthony, ID 83445
Phone (208) 624-4100

335 E Main St
Ste 1
Saint Anthony, ID 83445

20 N 3rd E
Saint Anthony, ID 83445
Phone (208) 624-4100

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1992903561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834450018",
            "telephone_number": "208-356-4900",
            "fax_number": "208-624-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 E MAIN ST STE 3",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834451546",
            "telephone_number": "208-356-4900",
            "fax_number": "208-624-4030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "72 S 1st E Ste 103",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834401902",
            "country_code": "US",
            "telephone_number": "208-356-4900",
            "fax_number": "208-612-6118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SORENSEN",
        "first_name": "LEIF",
        "middle_name": "HOLBROOK",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-27666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Anthony, ID

Sources for this page

Verify at the official NPI Registry.