Provider Demographics
NPI:1689106973
Name:WARREN, SONYA (MA,NCC)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:MA,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 CAMBRIDGE HEIGHTS PL NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-8673
Mailing Address - Country:US
Mailing Address - Phone:704-748-0889
Mailing Address - Fax:
Practice Address - Street 1:919 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2355
Practice Address - Country:US
Practice Address - Phone:704-660-6854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-28
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA12983101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional