Provider Demographics
NPI:1457862500
Name:LOVE, SONYA RENA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:RENA
Last Name:LOVE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11035 ASCOT CIR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-5079
Mailing Address - Country:US
Mailing Address - Phone:540-847-1209
Mailing Address - Fax:
Practice Address - Street 1:10712 BALLANTRAYE DR STE 312
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-4702
Practice Address - Country:US
Practice Address - Phone:540-847-1209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005746101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty