MEDICARE: MS. SONYA LYNN BRYCE NCC, LSATP, LPC

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	101YP2500X	Professional Counselor	0701003322	VA
2	101YP2500X	Professional Counselor	LPC-14494	AZ

General Provider Information

NPI Number	:	1649216854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SONYA LYNN BRYCE NCC, LSATP, LPC

Provider Business Mailing Address
First Line	:	9202 CENTER OAK CT
Second Line	:
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23116-2744
Country	:	US
Telephone Number	:
Fax Number	:	480-256-1010

Provider Business Practice Location Address
First Line	:	7051 HEATHCOTE VILLAGE WAY STE 115
Second Line	:
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3197
Country	:	US
Telephone Number	:	804-207-6737
Fax Number	:

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	01/18/2024

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