Provider Demographics
NPI:1326405168
Name:ENGESSER, TONYA SHEREE (MA COUNSELING)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:SHEREE
Last Name:ENGESSER
Suffix:
Gender:F
Credentials:MA COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 JERICHO RD
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0797
Mailing Address - Country:US
Mailing Address - Phone:701-516-6294
Mailing Address - Fax:
Practice Address - Street 1:1915 N KAVANEY DR. THE COUNSELORS
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501
Practice Address - Country:US
Practice Address - Phone:701-516-6294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND101YA0400X101YM0800X
ND101YP2500X101YP2500X
ND106H00000X106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist