Provider Demographics
NPI:1225584626
Name:BRYANT, LONTONIA (LCMHC)
Entity Type:Individual
Prefix:
First Name:LONTONIA
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2444 COMMERCE RD STE 127
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-7561
Mailing Address - Country:US
Mailing Address - Phone:910-518-8644
Mailing Address - Fax:910-685-7766
Practice Address - Street 1:2444 COMMERCE RD STE 127
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-7561
Practice Address - Country:US
Practice Address - Phone:910-518-8644
Practice Address - Fax:910-685-7766
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2022-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22878101YA0400X
NCCSAC-14881101YA0400X
NC12720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)