Provider Demographics
NPI:1457369977
Name:ALLEN, SONDRA KAY (LPCC, LMSW)
Entity Type:Individual
Prefix:
First Name:SONDRA
Middle Name:KAY
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPCC, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:TATUM
Mailing Address - State:NM
Mailing Address - Zip Code:88267-0102
Mailing Address - Country:US
Mailing Address - Phone:505-398-2842
Mailing Address - Fax:
Practice Address - Street 1:920 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-5529
Practice Address - Country:US
Practice Address - Phone:505-393-3168
Practice Address - Fax:505-397-4659
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0796101YM0800X
NMM-16061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00046300Medicaid
NM00R848OtherBLUE CROSS BLUE SHIELD