Provider Demographics
NPI:1316372592
Name:CLAY, TONYA ALICIA (LMFT)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:ALICIA
Last Name:CLAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 WILLIAM E SUMMERS III AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40211-4312
Mailing Address - Country:US
Mailing Address - Phone:502-974-3013
Mailing Address - Fax:
Practice Address - Street 1:1000 SOUTH 5TH STREET
Practice Address - Street 2:FAMILY & CHILDREN'S PLACE
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203
Practice Address - Country:US
Practice Address - Phone:502-893-3900
Practice Address - Fax:502-882-9237
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0864106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist