Provider Demographics
NPI:1639676117
Name:HUNTER, TASHA S (LCSW-A)
Entity Type:Individual
Prefix:MRS
First Name:TASHA
Middle Name:S
Last Name:HUNTER
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 WINGSPREAD DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-9625
Mailing Address - Country:US
Mailing Address - Phone:919-440-5152
Mailing Address - Fax:
Practice Address - Street 1:407 WINGSPREAD DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-9625
Practice Address - Country:US
Practice Address - Phone:919-440-5152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0116471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical