Provider Demographics
NPI:1881384568
Name:ABRAHAM, SONYA LYNN (LMSW)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:LYNN
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2826 W LOCUST ST STE 2A
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-3354
Mailing Address - Country:US
Mailing Address - Phone:563-445-8707
Mailing Address - Fax:563-445-8673
Practice Address - Street 1:2826 W LOCUST ST STE 2A
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-3354
Practice Address - Country:US
Practice Address - Phone:563-445-8707
Practice Address - Fax:563-445-8673
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1136661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical