Provider Demographics
NPI:1467637728
Name:EPPS, HONTAH TENEA (LCSW, MSW)
Entity Type:Individual
Prefix:MS
First Name:HONTAH
Middle Name:TENEA
Last Name:EPPS
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 TRAVERTINE TER
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-3697
Mailing Address - Country:US
Mailing Address - Phone:704-904-8312
Mailing Address - Fax:
Practice Address - Street 1:1408 TRAVERTINE TER
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-3697
Practice Address - Country:US
Practice Address - Phone:704-904-8312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC124871041C0700X
NCC0060921041C0700X
FLSW211951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106986Medicaid