Provider Demographics
NPI:1689045114
Name:HARRISON, SONJA (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 T ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1842
Mailing Address - Country:US
Mailing Address - Phone:202-601-3200
Mailing Address - Fax:
Practice Address - Street 1:1555 CONNECTICUT AVE NW STE 4E
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-601-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500818001041C0700X
DCLG50080575104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker