Provider Demographics
NPI:1326272998
Name:TONEY, JUANITA DARLENE (LPC, Q-SAP)
Entity Type:Individual
Prefix:
First Name:JUANITA
Middle Name:DARLENE
Last Name:TONEY
Suffix:
Gender:F
Credentials:LPC, Q-SAP
Other - Prefix:
Other - First Name:MISSY
Other - Middle Name:
Other - Last Name:TONEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC, Q-SAP
Mailing Address - Street 1:5818 N PARK RD
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4619
Mailing Address - Country:US
Mailing Address - Phone:423-874-1993
Mailing Address - Fax:423-874-1993
Practice Address - Street 1:747 BATTLEFIELD PKWY
Practice Address - Street 2:STE 1458 2B
Practice Address - City:FT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3923
Practice Address - Country:US
Practice Address - Phone:423-322-2360
Practice Address - Fax:423-874-1993
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000002430101YP2500X
GALPC005301101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA160416020AMedicaid