Provider Demographics
NPI:1699151944
Name:ROBERTS, SONIA A (LMHC)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:A
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 WAGES WAY
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-8057
Mailing Address - Country:US
Mailing Address - Phone:904-962-2826
Mailing Address - Fax:
Practice Address - Street 1:900 CESERY BLVD
Practice Address - Street 2:SUITE 111
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-5667
Practice Address - Country:US
Practice Address - Phone:904-962-2826
Practice Address - Fax:904-309-9935
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-09
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13275101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health