Provider Demographics
NPI:1215595004
Name:SONDAG, BRETT (MA RMHI)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:SONDAG
Suffix:
Gender:M
Credentials:MA RMHI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 WOOD ST.
Mailing Address - Street 2:STE. 215, 218, 220
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237
Mailing Address - Country:US
Mailing Address - Phone:941-677-3366
Mailing Address - Fax:
Practice Address - Street 1:2033 WOOD ST.
Practice Address - Street 2:STE. 215, 218, 220
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237
Practice Address - Country:US
Practice Address - Phone:941-677-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
FLIMH17754101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)