MEDICARE: SONIA L JACKSON-SUGGS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	292418	KY

General Provider Information

NPI Number	:	1235093089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA L JACKSON-SUGGS

Provider Business Mailing Address
First Line	:	4808 PADDOCK SPRINGS DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40299-3795
Country	:	US
Telephone Number	:	502-314-7520
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 BARRET AVE STE 222
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40204-1733
Country	:	US
Telephone Number	:	502-314-7520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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Directions to “ SONIA L JACKSON-SUGGS ” Practice Location

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