Individual
TARA LAVONA SORENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1709 MOON ST NE, ALBUQUERQUE, NM 87112-3935
(505) 271-0329
(505) 271-4957
Mailing address
1709 MOON ST NE, ALBUQUERQUE, NM 87112-3935
(505) 271-0329
(505) 271-4957
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SWB-2024-1224
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123109
—
OR
05
—
82002037
—
NM
Enumeration date
02/25/2008
Last updated
05/30/2025
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