Provider Demographics
NPI:1295031086
Name:NEWBERRY, SONJA RICHELE (LPC, MA, DCC)
Entity type:Individual
Prefix:DR
First Name:SONJA
Middle Name:RICHELE
Last Name:NEWBERRY
Suffix:
Gender:F
Credentials:LPC, MA, DCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 E CROGAN ST UNIT 1171
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-0411
Mailing Address - Country:US
Mailing Address - Phone:770-637-5745
Mailing Address - Fax:
Practice Address - Street 1:223 SCENIC HIGHWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046
Practice Address - Country:US
Practice Address - Phone:678-637-1182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005907101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor