Healthcare Provider Details

I. General information

NPI: 1508324120
Provider Name (Legal Business Name): SONIE WILLIAMS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2019
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 FORTUNE RD
WEST MIDDLETOWN NY
10941
US

IV. Provider business mailing address

2094 ALBANY POST RD
MONTROSE NY
10548-1454
US

V. Phone/Fax

Practice location:
  • Phone: 845-673-7123
  • Fax: 845-692-2889
Mailing address:
  • Phone: 914-737-4400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number105634-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: