Provider Demographics
NPI:1467162446
Name:KITTRELL, TONI FLEMING (LCMHC-A)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:FLEMING
Last Name:KITTRELL
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5000 FALLS OF NEUSE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-5480
Mailing Address - Country:US
Mailing Address - Phone:919-865-8710
Mailing Address - Fax:919-784-9184
Practice Address - Street 1:5000 FALLS OF NEUSE RD STE 300
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-5480
Practice Address - Country:US
Practice Address - Phone:919-865-8710
Practice Address - Fax:919-784-9184
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18060101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health