Provider Demographics
NPI:1891430955
Name:GUNN, TONY II (LICSW)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:GUNN
Suffix:II
Gender:M
Credentials:LICSW
Other - Prefix:MR
Other - First Name:TONY
Other - Middle Name:LEVON
Other - Last Name:GUNN-TOLBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:3056 RALSTON RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-5028
Mailing Address - Country:US
Mailing Address - Phone:850-304-4244
Mailing Address - Fax:
Practice Address - Street 1:1956 S UNIVERSITY BLVD STE J-297
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-2929
Practice Address - Country:US
Practice Address - Phone:251-268-9944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5404G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker