Provider Demographics
NPI:1316518509
Name:SORENSEN, ARIEL TAWNEY
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:TAWNEY
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 DUNCAN AVE APT 31
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-2126
Mailing Address - Country:US
Mailing Address - Phone:719-447-7916
Mailing Address - Fax:
Practice Address - Street 1:22 DUNCAN AVE APT 31
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-2126
Practice Address - Country:US
Practice Address - Phone:719-447-7916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)