Provider Demographics
NPI:1679299184
Name:RAGON, TOBI (LCMHC-A)
Entity Type:Individual
Prefix:MRS
First Name:TOBI
Middle Name:
Last Name:RAGON
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 IRON GATE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6624
Mailing Address - Country:US
Mailing Address - Phone:910-202-9113
Mailing Address - Fax:
Practice Address - Street 1:2601 IRON GATE DR STE 101
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6624
Practice Address - Country:US
Practice Address - Phone:910-202-9113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17994101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional