Provider Demographics
NPI:1083150916
Name:SONNIER, CINDY PETITHOMME (LCSW)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:PETITHOMME
Last Name:SONNIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:PETITHOMME
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DSW, LCSW
Mailing Address - Street 1:13475 ATLANTIC BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-3290
Mailing Address - Country:US
Mailing Address - Phone:888-310-6692
Mailing Address - Fax:888-572-9773
Practice Address - Street 1:13475 ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-3291
Practice Address - Country:US
Practice Address - Phone:888-310-6692
Practice Address - Fax:888-572-9773
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2023-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0106711041C0700X
NCC0116671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical