Provider Demographics
NPI:1881935872
Name:ADAMENKO, SOFIIA (PMHNP)
Entity type:Individual
Prefix:
First Name:SOFIIA
Middle Name:
Last Name:ADAMENKO
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:SOFIA
Other - Middle Name:
Other - Last Name:ADAMENKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11724 BORCHETTA DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-1697
Mailing Address - Country:US
Mailing Address - Phone:315-489-5155
Mailing Address - Fax:
Practice Address - Street 1:11724 BORCHETTA DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-1697
Practice Address - Country:US
Practice Address - Phone:315-489-5155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC313455163WP0808X, 163WA0400X
NC2024065568363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)