Provider Demographics
NPI:1184016743
Name:THOMAS, SONYA (RN, LCSW)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RN, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1087 ERIE CIR
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-6528
Mailing Address - Country:US
Mailing Address - Phone:404-308-9100
Mailing Address - Fax:
Practice Address - Street 1:1087 ERIE CIR
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-6528
Practice Address - Country:US
Practice Address - Phone:404-308-9100
Practice Address - Fax:404-393-9011
Is Sole Proprietor?:No
Enumeration Date:2015-02-19
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0051641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical