Provider Demographics
NPI:1669946455
Name:PARKS, TONYA YVETTE (LPC)
Entity type:Individual
Prefix:MS
First Name:TONYA
Middle Name:YVETTE
Last Name:PARKS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:773 STONEROOT DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7083
Mailing Address - Country:US
Mailing Address - Phone:803-348-9698
Mailing Address - Fax:803-751-4438
Practice Address - Street 1:4500 STUART ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29207-5700
Practice Address - Country:US
Practice Address - Phone:803-751-5911
Practice Address - Fax:803-751-4438
Is Sole Proprietor?:No
Enumeration Date:2019-01-15
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5173101YP2500X
SC5386101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional