Provider Demographics
NPI:1548589971
Name:TONEY, ANITA TILLOTSON (LPC)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:TILLOTSON
Last Name:TONEY
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 1:203 LOY DR
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-2243
Mailing Address - Country:US
Mailing Address - Phone:919-496-4935
Mailing Address - Fax:919-496-4935
Practice Address - Street 1:510 DABNEY DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-3946
Practice Address - Country:US
Practice Address - Phone:252-430-4436
Practice Address - Fax:252-430-4436
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2447101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health