Provider Demographics
NPI:1437800968
Name:ZEZZA, SONYA-LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:SONYA-LEE
Middle Name:
Last Name:ZEZZA
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 1:22 COMARES AVE UNIT 8B
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-3764
Mailing Address - Country:US
Mailing Address - Phone:617-680-2232
Mailing Address - Fax:
Practice Address - Street 1:5118 SR A1A S
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-3208
Practice Address - Country:US
Practice Address - Phone:904-640-8897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19315101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor