Provider Demographics
NPI:1265095343
Name:TONI GEORGIANA, LCSW, PLLC
Entity type:Organization
Organization Name:TONI GEORGIANA, LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGIANA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:843-957-5455
Mailing Address - Street 1:5613 DURALEIGH RD STE 101
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-2694
Mailing Address - Country:US
Mailing Address - Phone:984-205-7283
Mailing Address - Fax:
Practice Address - Street 1:5613 DURALEIGH RD STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2694
Practice Address - Country:US
Practice Address - Phone:984-205-7283
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)