Healthcare Provider Details

I. General information

NPI: 1598455750
Provider Name (Legal Business Name): SONIA DENISE DEWITT LCSW, LCASA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 NEW BRIDGE ST
JACKSONVILLE NC
28540-4708
US

IV. Provider business mailing address

707 BLUE JEAN RD
WHITEVILLE NC
28472-4318
US

V. Phone/Fax

Practice location:
  • Phone: 910-388-6070
  • Fax:
Mailing address:
  • Phone: 910-445-0086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC019285
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: