Provider Demographics
NPI:1346663234
Name:SORENSON, TRISTA (LPC)
Entity type:Individual
Prefix:MS
First Name:TRISTA
Middle Name:
Last Name:SORENSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 E RAM ROCK RD
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-4624
Mailing Address - Country:US
Mailing Address - Phone:303-818-2630
Mailing Address - Fax:
Practice Address - Street 1:2301 E RAM ROCK RD
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-4624
Practice Address - Country:US
Practice Address - Phone:720-458-1343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-28
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0013014101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health