Provider Demographics
NPI:1184808297
Name:KALIS, SONNA (LCPC)
Entity type:Individual
Prefix:MS
First Name:SONNA
Middle Name:
Last Name:KALIS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:SONNY
Other - Middle Name:
Other - Last Name:KALIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:438 CAPSTON COURT
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-1153
Mailing Address - Country:US
Mailing Address - Phone:410-615-2263
Mailing Address - Fax:410-578-6228
Practice Address - Street 1:600 RIDGELY AVENUE
Practice Address - Street 2:SUITE 210
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1086
Practice Address - Country:US
Practice Address - Phone:410-615-2263
Practice Address - Fax:410-518-6228
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0639101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional