Provider Demographics
NPI:1598498859
Name:SPIVEY, TONYA (LMHCA)
Entity Type:Individual
Prefix:MS
First Name:TONYA
Middle Name:
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 STONE RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6528
Mailing Address - Country:US
Mailing Address - Phone:919-818-3658
Mailing Address - Fax:
Practice Address - Street 1:2321 CRABTREE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-2263
Practice Address - Country:US
Practice Address - Phone:919-848-9108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health