Provider Demographics
NPI:1629676333
Name:SONUGA, CHRISTIANA OLUWATOYIN (LCSW, ACM-SW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIANA
Middle Name:OLUWATOYIN
Last Name:SONUGA
Suffix:
Gender:F
Credentials:LCSW, ACM-SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 CLAIRIDGE ELM TRL
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-7753
Mailing Address - Country:US
Mailing Address - Phone:770-630-4659
Mailing Address - Fax:
Practice Address - Street 1:699 CLAIRIDGE ELM TRL
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-7753
Practice Address - Country:US
Practice Address - Phone:770-630-4659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0053951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical