Provider Demographics
NPI:1740446665
Name:STEPHENS, SONDRA WILLIS I (LPC)
Entity type:Individual
Prefix:MRS
First Name:SONDRA
Middle Name:WILLIS
Last Name:STEPHENS
Suffix:I
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3517 BRANDON AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-1523
Mailing Address - Country:US
Mailing Address - Phone:540-345-6781
Mailing Address - Fax:
Practice Address - Street 1:3517 BRANDON AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1523
Practice Address - Country:US
Practice Address - Phone:540-345-6781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004190101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional