Provider Demographics
NPI:1952459448
Name:SONSIRE, THERESA STEERS
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:STEERS
Last Name:SONSIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:THERESA
Other - Middle Name:STEERS
Other - Last Name:SONSIRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:4 STANLEY PL
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2766
Mailing Address - Country:US
Mailing Address - Phone:631-979-3913
Mailing Address - Fax:
Practice Address - Street 1:4 STANLEY PL
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11788-2766
Practice Address - Country:US
Practice Address - Phone:631-979-3913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR030663104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY073355OtherVALUEOPTIONS
NY073355OtherVALUEOPTIONS