Provider Demographics
NPI:1427533314
Name:BOGGS, SONYA YEATORMA (DMFT, DHA, LCSW)
Entity type:Individual
Prefix:DR
First Name:SONYA
Middle Name:YEATORMA
Last Name:BOGGS
Suffix:
Gender:F
Credentials:DMFT, DHA, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N 8TH ST UNIT 915
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-1018
Mailing Address - Country:US
Mailing Address - Phone:240-818-9797
Mailing Address - Fax:
Practice Address - Street 1:5070 PARKSIDE AVE STE 3500A
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-4749
Practice Address - Country:US
Practice Address - Phone:240-818-9797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
102L00000X
DEQ1-00126781041C0700X
MD29299104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical