Provider Demographics
NPI:1982269007
Name:COLLINS, SONJA ANN (CADC)
Entity Type:Individual
Prefix:MRS
First Name:SONJA
Middle Name:ANN
Last Name:COLLINS
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W 76TH ST STE 326
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60620-1696
Mailing Address - Country:US
Mailing Address - Phone:708-595-6449
Mailing Address - Fax:773-966-5229
Practice Address - Street 1:400 W 76TH ST STE 326
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-1696
Practice Address - Country:US
Practice Address - Phone:708-595-6449
Practice Address - Fax:773-966-5229
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL30113101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional