Provider Demographics
NPI:1285174797
Name:LEE, SONYA LEVETTE (EDD, CSAC, CAADC,)
Entity type:Individual
Prefix:DR
First Name:SONYA
Middle Name:LEVETTE
Last Name:LEE
Suffix:
Gender:F
Credentials:EDD, CSAC, CAADC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 E CONSTANCE RD
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-3004
Mailing Address - Country:US
Mailing Address - Phone:757-539-0474
Mailing Address - Fax:757-539-8394
Practice Address - Street 1:1003 INDIAN POINT RD
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8396
Practice Address - Country:US
Practice Address - Phone:757-572-1517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1670101YA0400X
VA0710102165101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)