Provider Demographics
NPI:1275096901
Name:BROWN, SONJI NICHOLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SONJI
Middle Name:NICHOLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4513 MOON VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-3623
Mailing Address - Country:US
Mailing Address - Phone:404-579-8421
Mailing Address - Fax:
Practice Address - Street 1:560 HIGHWAY 138 W
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30238-2222
Practice Address - Country:US
Practice Address - Phone:770-837-8253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-10
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0065601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical