Provider Demographics
NPI:1053667881
Name:BRISSEY, TONYA RENEE (LCSW, LAADC)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:RENEE
Last Name:BRISSEY
Suffix:
Gender:F
Credentials:LCSW, LAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 INDUSTRIAL ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002-0757
Mailing Address - Country:US
Mailing Address - Phone:530-241-4100
Mailing Address - Fax:530-722-1115
Practice Address - Street 1:1201 INDUSTRIAL ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0757
Practice Address - Country:US
Practice Address - Phone:530-241-4100
Practice Address - Fax:530-241-4117
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA03-061077101YA0400X
CA710471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)