Individual
SHAWN SORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSWA, QMHP, CADCIII
Contact information
Practice address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 631-9636
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 631-9636
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
25-05-30158
OR
101YM0800X
Mental Health Counselor
24-QMHPC-001493
OR
1041C0700X
Clinical Social Worker
Primary
A14900
OR
Other
Enumeration date
08/14/2020
Last updated
05/29/2025
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