Provider Demographics
NPI:1235515289
Name:BATTLE, TONYA E (PSYD LCPC)
Entity Type:Individual
Prefix:DR
First Name:TONYA
Middle Name:E
Last Name:BATTLE
Suffix:
Gender:F
Credentials:PSYD LCPC
Other - Prefix:DR
Other - First Name:TONYA
Other - Middle Name:E
Other - Last Name:BANKS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DR TONYA BATTLE LLC
Mailing Address - Street 1:210 N HAMMES AVE STE 103B
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6688
Mailing Address - Country:US
Mailing Address - Phone:815-582-3939
Mailing Address - Fax:
Practice Address - Street 1:210 N HAMMES AVE STE 103B
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6688
Practice Address - Country:US
Practice Address - Phone:815-582-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-31
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180009185101YP2500X
IL071010703103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1558023119OtherGROUP PRACTICE