Provider Demographics
NPI:1891702635
Name:DEMPS-BENN, TONYA LYNN (LMHC)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:LYNN
Last Name:DEMPS-BENN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60015
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32906-0015
Mailing Address - Country:US
Mailing Address - Phone:321-952-8646
Mailing Address - Fax:321-953-0165
Practice Address - Street 1:2003 MATTISON DR NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-3941
Practice Address - Country:US
Practice Address - Phone:321-952-8646
Practice Address - Fax:321-953-0165
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4190101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health