Healthcare Provider Details

I. General information

NPI: 1982916656
Provider Name (Legal Business Name): LYNN SORENSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNN BRIMHALL

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 E MAIN ST
MESA AZ
85203-8820
US

IV. Provider business mailing address

4061 E DES MOINES ST
MESA AZ
85205-6231
US

V. Phone/Fax

Practice location:
  • Phone: 833-855-9973
  • Fax: 602-655-9620
Mailing address:
  • Phone: 480-447-7073
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-15265
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: