Provider Demographics
NPI:1992219414
Name:CHESTNUT, SONJA SHARON MARLIS (LCSW-C, LICSW)
Entity Type:Individual
Prefix:MS
First Name:SONJA
Middle Name:SHARON MARLIS
Last Name:CHESTNUT
Suffix:
Gender:F
Credentials:LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14311 ARCTIC AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-2253
Mailing Address - Country:US
Mailing Address - Phone:202-321-8429
Mailing Address - Fax:
Practice Address - Street 1:13111 MORAN CT
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-3922
Practice Address - Country:US
Practice Address - Phone:301-977-0824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-20
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500819621041C0700X
MD217811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical