Provider Demographics
NPI:1962396820
Name:SORUM, AMBER AUGUSTA (LAPC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:AUGUSTA
Last Name:SORUM
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:AUGUSTA
Other - Last Name:MITZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 2ND ST NW
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58072-2971
Mailing Address - Country:US
Mailing Address - Phone:701-840-1924
Mailing Address - Fax:
Practice Address - Street 1:333 2ND ST NW
Practice Address - Street 2:
Practice Address - City:VALLEY CITY
Practice Address - State:ND
Practice Address - Zip Code:58072-2971
Practice Address - Country:US
Practice Address - Phone:701-840-1924
Practice Address - Fax:866-862-6966
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1446-6-1-25A101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional