Provider Demographics
NPI:1053635037
Name:MARTIN, SONJA K (LPC)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:K
Last Name:MARTIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-4523
Mailing Address - Country:US
Mailing Address - Phone:919-810-1466
Mailing Address - Fax:
Practice Address - Street 1:742 MCKNIGHT DR
Practice Address - Street 2:SUITE 200
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7764
Practice Address - Country:US
Practice Address - Phone:919-332-1819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-20
Last Update Date:2010-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4718101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health