Provider Demographics
NPI:1750401808
Name:BELLETTI, SONYA SOMIKA (LCSW)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:SOMIKA
Last Name:BELLETTI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 SW 8TH ST
Mailing Address - Street 2:#142
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-3529
Mailing Address - Country:US
Mailing Address - Phone:954-383-1656
Mailing Address - Fax:305-455-9695
Practice Address - Street 1:9526 NE 2ND AVE
Practice Address - Street 2:SUITE 202F
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2750
Practice Address - Country:US
Practice Address - Phone:954-383-1656
Practice Address - Fax:305-259-0818
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 124851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL766214900-01Medicaid