Provider Demographics
NPI:1912212812
Name:CRABTREE-NELSON, SONYA V (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:SONYA
Middle Name:V
Last Name:CRABTREE-NELSON
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7443 N ROGERS AVE
Mailing Address - Street 2:APT. 3E
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-1690
Mailing Address - Country:US
Mailing Address - Phone:847-804-7264
Mailing Address - Fax:
Practice Address - Street 1:5138 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2828
Practice Address - Country:US
Practice Address - Phone:847-804-7264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0094951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical