MEDICARE: MRS. SONJA LYNNAE ALLEN LPCC

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	0986	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12269136	OTHER		CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124306832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SONJA LYNNAE ALLEN LPCC

Provider Business Mailing Address
First Line	:	22 BLUEGRASS DR
Second Line	:
City	:	BEAVER DAM
State	:	KY
Zip	:	42320-9598
Country	:	US
Telephone Number	:	270-955-6218
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 E MCMURTRY AVE STE 107
Second Line	:
City	:	HARTFORD
State	:	KY
Zip	:	42347-1634
Country	:	US
Telephone Number	:	270-955-6218
Fax Number	:

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

Provider Enumeration Date	:	07/29/2011
Last Update Date	:	04/10/2023

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