Provider Demographics
NPI:1699169490
Name:SOJKA, MONICA JEAN (LISW-CP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:JEAN
Last Name:SOJKA
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 2ND AVE N STE 206F
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-8209
Mailing Address - Country:US
Mailing Address - Phone:843-360-0053
Mailing Address - Fax:410-893-5227
Practice Address - Street 1:1016 2ND AVE N STE 206F
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-8209
Practice Address - Country:US
Practice Address - Phone:843-360-0053
Practice Address - Fax:410-893-5227
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-19
Last Update Date:2020-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC105861041C0700X
MD091851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSW1242Medicaid