Provider Demographics
NPI:1487996724
Name:WOLFROM, SONYA A (LSW)
Entity type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:A
Last Name:WOLFROM
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 S SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-2827
Mailing Address - Country:US
Mailing Address - Phone:570-660-1002
Mailing Address - Fax:
Practice Address - Street 1:705 WASHINGTON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-5355
Practice Address - Country:US
Practice Address - Phone:570-321-6390
Practice Address - Fax:570-321-6393
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0241881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical