MEDICARE: VERONICA SONNER LCSW

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	1041C0700X	Clinical Social Worker	009290	CT
2	1041C0700X	Clinical Social Worker	C011226	NC

General Provider Information

NPI Number	:	1104172766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA SONNER LCSW

Provider Business Mailing Address
First Line	:	2530 SUNNYSIDE SCHOOL RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28312-6917
Country	:	US
Telephone Number	:	203-892-1480
Fax Number	:

Provider Business Practice Location Address
First Line	:	1017 HOPE MILLS RD
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-4234
Country	:	US
Telephone Number	:	910-491-6011
Fax Number	:

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

Provider Enumeration Date	:	07/31/2012
Last Update Date	:	05/27/2021

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