Provider Demographics
NPI:1386010106
Name:SORRA, MIHKEL (LMSW)
Entity type:Individual
Prefix:
First Name:MIHKEL
Middle Name:
Last Name:SORRA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 19TH ST APT 3L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-1009
Mailing Address - Country:US
Mailing Address - Phone:410-336-8154
Mailing Address - Fax:
Practice Address - Street 1:151 19TH ST APT 3L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-1009
Practice Address - Country:US
Practice Address - Phone:410-336-8154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-16
Last Update Date:2015-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY095690-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist