Provider Demographics
NPI:1730786963
Name:STEWARD, SONYA (LAC)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:STEWARD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:
Other - Last Name:RAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SAC
Mailing Address - Street 1:7207 SHILLING CIR
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-5404
Mailing Address - Country:US
Mailing Address - Phone:903-280-3808
Mailing Address - Fax:
Practice Address - Street 1:1124 MAIN AVE
Practice Address - Street 2:
Practice Address - City:DIERKS
Practice Address - State:AR
Practice Address - Zip Code:71833-9421
Practice Address - Country:US
Practice Address - Phone:870-356-7404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
ARA2309009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)