Provider Demographics
NPI:1487053088
Name:SUKUP, SONYA (LMHP)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:SUKUP
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1686
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-1686
Mailing Address - Country:US
Mailing Address - Phone:308-293-1385
Mailing Address - Fax:
Practice Address - Street 1:15 W 22ND ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-5328
Practice Address - Country:US
Practice Address - Phone:308-224-0596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10334101YM0800X
NE4999101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health