Provider Demographics
NPI:1457738411
Name:MIDGETT, SODEYA DARQUIS (MSW,LCSWA)
Entity Type:Individual
Prefix:
First Name:SODEYA
Middle Name:DARQUIS
Last Name:MIDGETT
Suffix:
Gender:F
Credentials:MSW,LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 NAVAHO DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7335
Mailing Address - Country:US
Mailing Address - Phone:252-288-7300
Mailing Address - Fax:
Practice Address - Street 1:1001 NAVAHO DRIVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609
Practice Address - Country:US
Practice Address - Phone:252-288-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0090391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical