Basic Information
Provider Information
NPI: 1538127964
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARRIS
FirstName: SONIA
MiddleName: RENEE
NamePrefix:  
NameSuffix:  
Credential: M.ED. LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: LINDSEY
OtherFirstName: SONYA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1502 W NC HIGHWAY 54 STE 103
Address2:  
City: DURHAM
State: NC
PostalCode: 277075572
CountryCode: US
TelephoneNumber: 9193540840
FaxNumber:  
Practice Location
Address1: 1055 DRESSER CT
Address2:  
City: RALEIGH
State: NC
PostalCode: 276097323
CountryCode: US
TelephoneNumber: 9197923920
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/03/2006
LastUpdateDate: 04/19/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X13651NCY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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