Provider Demographics
NPI:1932503174
Name:CRITTENDEN, SOPHIA LAYANA (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:LAYANA
Last Name:CRITTENDEN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 TRENT BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-4537
Mailing Address - Country:US
Mailing Address - Phone:252-638-7875
Mailing Address - Fax:252-638-7586
Practice Address - Street 1:1917 TRENT BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4537
Practice Address - Country:US
Practice Address - Phone:252-638-7875
Practice Address - Fax:252-638-7586
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW17754101YM0800X
NCP0092521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health