Provider Demographics
NPI:1417011610
Name:GOODEN-ALEXIS, SONIA (MED LMHC, LPCS)
Entity Type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:
Last Name:GOODEN-ALEXIS
Suffix:
Gender:F
Credentials:MED LMHC, LPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 HILLANDALE RD
Mailing Address - Street 2:SUITE 1B-213
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2659
Mailing Address - Country:US
Mailing Address - Phone:919-617-1209
Mailing Address - Fax:
Practice Address - Street 1:3125 POPLARWOOD CT
Practice Address - Street 2:SUITE 203
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1084
Practice Address - Country:US
Practice Address - Phone:919-617-1209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5736101YM0800X
NC6748101YM0800X
NCS6748101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104076Medicaid