Provider Demographics
NPI:1043509532
Name:WENTZ, SONJA R (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:SONJA
Middle Name:R
Last Name:WENTZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 12TH CT SW STE 5
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-1022
Mailing Address - Country:US
Mailing Address - Phone:360-870-3189
Mailing Address - Fax:360-352-7881
Practice Address - Street 1:2617 12TH CT SW STE 5
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1022
Practice Address - Country:US
Practice Address - Phone:360-870-3189
Practice Address - Fax:360-352-7881
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00009689101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health