Provider Demographics
NPI:1063904571
Name:MORMAN, TENEYA D (LCMHC / LCAS)
Entity type:Individual
Prefix:
First Name:TENEYA
Middle Name:D
Last Name:MORMAN
Suffix:
Gender:F
Credentials:LCMHC / LCAS
Other - Prefix:
Other - First Name:TENEYA
Other - Middle Name:DENE MORMAN
Other - Last Name:LOVE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 51927
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27717-1927
Mailing Address - Country:US
Mailing Address - Phone:919-423-1402
Mailing Address - Fax:
Practice Address - Street 1:5613 DURALEIGH RD STE 161
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2709
Practice Address - Country:US
Practice Address - Phone:919-423-1402
Practice Address - Fax:828-544-1201
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13502101YM0800X, 101YP2500X, 101YP2500X
NCA13502101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health