Provider Demographics
NPI:1073761888
Name:TONEY, LARA C (MA)
Entity type:Individual
Prefix:MS
First Name:LARA
Middle Name:C
Last Name:TONEY
Suffix:
Gender:
Credentials:MA
Other - Prefix:MS
Other - First Name:LARA
Other - Middle Name:C
Other - Last Name:GERST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:1205 WILDWOOD AVE NE
Mailing Address - Street 2:
Mailing Address - City:NAPAVINE
Mailing Address - State:WA
Mailing Address - Zip Code:98532-9280
Mailing Address - Country:US
Mailing Address - Phone:360-870-3706
Mailing Address - Fax:
Practice Address - Street 1:1205 WILDWOOD AVE NE
Practice Address - Street 2:
Practice Address - City:NAPAVINE
Practice Address - State:WA
Practice Address - Zip Code:98532-9280
Practice Address - Country:US
Practice Address - Phone:360-870-3706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002646101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health