Provider Demographics
NPI:1952093080
Name:SPELL, TONI VICTORIA (LCMHC-A)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:VICTORIA
Last Name:SPELL
Suffix:
Gender:F
Credentials:LCMHC-A
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:VICTORIA
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 LOOP ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328
Mailing Address - Country:US
Mailing Address - Phone:910-596-2221
Mailing Address - Fax:910-596-2229
Practice Address - Street 1:100 LOOP ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-4062
Practice Address - Country:US
Practice Address - Phone:910-596-2221
Practice Address - Fax:910-596-2229
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17518101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health