Provider Demographics
NPI:1336525377
Name:GERMAIN, SOWANIA CLAUDIE (LMHC)
Entity Type:Individual
Prefix:
First Name:SOWANIA
Middle Name:CLAUDIE
Last Name:GERMAIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 FARBER DR
Mailing Address - Street 2:
Mailing Address - City:BELLPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11713-1500
Mailing Address - Country:US
Mailing Address - Phone:631-286-0700
Mailing Address - Fax:
Practice Address - Street 1:11 FARBER DR
Practice Address - Street 2:
Practice Address - City:BELLPORT
Practice Address - State:NY
Practice Address - Zip Code:11713-1500
Practice Address - Country:US
Practice Address - Phone:631-286-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-31
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006664101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health