Provider Demographics
NPI:1104262997
Name:SONDAY, LISA (MSW, LMSW, CAADC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SONDAY
Suffix:
Gender:F
Credentials:MSW, LMSW, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5320 HOLIDAY TER STE 8
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-2100
Mailing Address - Country:US
Mailing Address - Phone:269-375-6079
Mailing Address - Fax:269-375-6078
Practice Address - Street 1:8036 MOORSBRIDGE RD
Practice Address - Street 2:SUITE #2
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-4419
Practice Address - Country:US
Practice Address - Phone:269-327-1438
Practice Address - Fax:269-427-6454
Is Sole Proprietor?:No
Enumeration Date:2013-05-20
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801092612104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker