Provider Demographics
NPI:1174824940
Name:FOLAYAN, SUNYA W (P-LCSW)
Entity Type:Individual
Prefix:
First Name:SUNYA
Middle Name:W
Last Name:FOLAYAN
Suffix:
Gender:F
Credentials:P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 E 20TH ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-2634
Mailing Address - Country:US
Mailing Address - Phone:704-264-9575
Mailing Address - Fax:
Practice Address - Street 1:808 E 20TH ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-2634
Practice Address - Country:US
Practice Address - Phone:704-264-9575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0060361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical