Provider Demographics
NPI:1639241664
Name:BRAVERMAN, SONYA A (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:SONYA
Middle Name:A
Last Name:BRAVERMAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4978 SENTINEL DRIVE
Mailing Address - Street 2:SUITE 505
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-3575
Mailing Address - Country:US
Mailing Address - Phone:301-204-4722
Mailing Address - Fax:
Practice Address - Street 1:4978 SENTINEL DRIVE
Practice Address - Street 2:SUITE 505
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-3575
Practice Address - Country:US
Practice Address - Phone:301-204-4722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD053461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD490957Medicare UPIN