Healthcare Provider Details

I. General information

NPI: 1649216854
Provider Name (Legal Business Name): SONYA LYNN BRYCE NCC, LSATP, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7051 HEATHCOTE VILLAGE WAY STE 115
GAINESVILLE VA
20155-3197
US

IV. Provider business mailing address

9202 CENTER OAK CT
MECHANICSVILLE VA
23116-2744
US

V. Phone/Fax

Practice location:
  • Phone: 804-207-6737
  • Fax:
Mailing address:
  • Phone:
  • Fax: 480-256-1010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701003322
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-14494
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: