Provider Demographics
NPI:1770061475
Name:DEWITT, SONYA PAULA (LMHC)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:PAULA
Last Name:DEWITT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7903 S PARWAY LN
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-8619
Mailing Address - Country:US
Mailing Address - Phone:509-867-7330
Mailing Address - Fax:509-867-7330
Practice Address - Street 1:7903 S PARWAY LN
Practice Address - Street 2:
Practice Address - City:CHENEY
Practice Address - State:WA
Practice Address - Zip Code:99004-8619
Practice Address - Country:US
Practice Address - Phone:509-867-7330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004512101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2110094Medicaid