Provider Demographics
NPI:1598026296
Name:SONNESSIE, JUDITH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:SONNESSIE
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 1:86 HALSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-3008
Mailing Address - Country:US
Mailing Address - Phone:646-236-0033
Mailing Address - Fax:
Practice Address - Street 1:86 HALSTEAD AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-3008
Practice Address - Country:US
Practice Address - Phone:646-236-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0374711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical