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Physician Compare National (NPI:1487656492)

HEALTHCARE PROVIDER: KRISTI SORELLE LCSW, BCD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1487656492
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 0244379659
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20091124000590
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name SORELLE
Individual professional last name
Provider First Name KRISTI
Individual professional first name
Provider Middle Name P
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 1981
Individual professional's medical school graduation year
Primary Specialty CLINICAL SOCIAL WORKER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 209 OLD HEWITT RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 3
Group Practice or individual's line 2 address
City WACO
Group Practice or individual's city
State TX
Group Practice or individual's state
Zip Code 767126599
Group Practice or individual's zip code (9 digits when available)
Phone Number 2544472762
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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