Provider Demographics
NPI:1497939615
Name:TINGLE, DONNA GRAY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:GRAY
Last Name:TINGLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 COMMONS BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-7766
Mailing Address - Country:US
Mailing Address - Phone:864-220-9115
Mailing Address - Fax:864-220-9513
Practice Address - Street 1:102 COMMONS BOULEVARD, SUITE C
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-7766
Practice Address - Country:US
Practice Address - Phone:864-220-9115
Practice Address - Fax:864-220-9513
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4568101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional