Provider Demographics
NPI:1154151793
Name:EFFA, SOPHIA MARIE (MA, AMFT)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:MARIE
Last Name:EFFA
Suffix:
Gender:X
Credentials:MA, AMFT
Other - Prefix:
Other - First Name:FIA
Other - Middle Name:
Other - Last Name:EFFA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, AMFT
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95518-0117
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:822 G ST STE 4
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6247
Practice Address - Country:US
Practice Address - Phone:707-502-2083
Practice Address - Fax:707-388-1896
Is Sole Proprietor?:No
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT147492101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health