Individual
MARLIS SORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
11 S MAIN ST, RANDOLPH, VT 05060-1330
(802) 728-4466
(802) 728-4197
Mailing address
PO BOX 263, EAST THETFORD, VT 05043-0263
(802) 356-1546
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000415
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010782
—
VT
01
—
14Y007415VT01
ANTHEM
VT
01
—
2027288
CIGNA
VT
01
—
39140
BLUE CROSS
VT
Enumeration date
10/16/2006
Last updated
07/08/2007
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