Healthcare Provider Details

I. General information

NPI: 1811800550
Provider Name (Legal Business Name): MARIA GAIL SORENSEN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1255 EDMONSON AVE NE SUITE 310
MONTICELLO MN
55362-5505
US

IV. Provider business mailing address

1255 EDMONSON AVE NE SUITE 310
MONTICELLO MN
55362-5505
US

V. Phone/Fax

Practice location:
  • Phone: 320-241-9925
  • Fax:
Mailing address:
  • Phone: 320-241-9925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23116
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: