Provider Demographics
NPI:1528359718
Name:MORALES, SONIA ESTELLE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:ESTELLE
Last Name:MORALES
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 1:12 NORTH SEVENTH AVENUE
Mailing Address - Street 2:(DEPT. OUT PT. CLINIC)
Mailing Address - City:MT. VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550
Mailing Address - Country:US
Mailing Address - Phone:914-361-7241
Mailing Address - Fax:914-664-6788
Practice Address - Street 1:12 NORTH SEVENTH AVENUE
Practice Address - Street 2:
Practice Address - City:MT. VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550
Practice Address - Country:US
Practice Address - Phone:914-361-7241
Practice Address - Fax:914-664-6788
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0703501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical