Provider Demographics
NPI:1689250912
Name:SEWELL, SUNNY MICHELLE (LPC)
Entity type:Individual
Prefix:
First Name:SUNNY
Middle Name:MICHELLE
Last Name:SEWELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 LAKEPOINTE DR # 15B
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-6411
Mailing Address - Country:US
Mailing Address - Phone:210-219-5893
Mailing Address - Fax:
Practice Address - Street 1:2025 LAKEPOINTE DR # 15B
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-6411
Practice Address - Country:US
Practice Address - Phone:210-219-5893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91570101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional