Provider Demographics
NPI:1417080672
Name:CONEY, SONJA (CAC)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:CONEY
Suffix:
Gender:F
Credentials:CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11000 W MCNICHOLS
Mailing Address - Street 2:SUITE B2- B4
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48222-0001
Mailing Address - Country:US
Mailing Address - Phone:313-863-5554
Mailing Address - Fax:313-863-4711
Practice Address - Street 1:11000 W MCNICHOLS
Practice Address - Street 2:SUITE B2- B4
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48222-0001
Practice Address - Country:US
Practice Address - Phone:313-863-5554
Practice Address - Fax:313-863-4711
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)