Healthcare Provider Details

I. General information

NPI: 1720539992
Provider Name (Legal Business Name): TARA RENEE SORENSON LCPC, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 N 27TH ST # 376
BILLINGS MT
59101-1121
US

IV. Provider business mailing address

821 N 27TH ST # 376
BILLINGS MT
59101-1121
US

V. Phone/Fax

Practice location:
  • Phone: 406-201-9353
  • Fax: 406-500-7654
Mailing address:
  • Phone: 406-201-9353
  • Fax: 406-500-7654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8434
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number3400
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: