Provider Demographics
NPI:1003165879
Name:STANLEY, SONNEE DA'NIEL (MED)
Entity Type:Individual
Prefix:
First Name:SONNEE
Middle Name:DA'NIEL
Last Name:STANLEY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9612 WELLS PKWY
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-1720
Mailing Address - Country:US
Mailing Address - Phone:304-888-2910
Mailing Address - Fax:
Practice Address - Street 1:9612 WELLS PKWY
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23503-1720
Practice Address - Country:US
Practice Address - Phone:304-888-2910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0777101Y00000X
WV2035101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0005489001Medicaid
WV0005489002Medicaid