Provider Demographics
NPI:1942783394
Name:HERNANDEZ, TONYA Y (LCSW)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:Y
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CCSD AREA SERVICE CENTER AT MOJAVE ESD
Mailing Address - Street 2:5240 GOLDFIELD ST
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032
Mailing Address - Country:US
Mailing Address - Phone:702-855-7518
Mailing Address - Fax:
Practice Address - Street 1:CCSD AREA SERVICE CENTER AT MOJAVE ESD
Practice Address - Street 2:5240 GOLDFIELD ST
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032
Practice Address - Country:US
Practice Address - Phone:702-855-7518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4689-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical