Provider Demographics
NPI:1689094427
Name:WRIGHT, SONYA ELAINE (LPC)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:ELAINE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 42413
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-0413
Mailing Address - Country:US
Mailing Address - Phone:404-550-1483
Mailing Address - Fax:
Practice Address - Street 1:3695 CASCADE RD SW STE F
Practice Address - Street 2:#169
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2146
Practice Address - Country:US
Practice Address - Phone:404-550-1483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003770101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional