Provider Demographics
NPI:1194367193
Name:COMBS, TONYA LEE (LCSW, LCAS)
Entity type:Individual
Prefix:MS
First Name:TONYA
Middle Name:LEE
Last Name:COMBS
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 TOPPIN CT
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-1020
Mailing Address - Country:US
Mailing Address - Phone:919-721-0418
Mailing Address - Fax:
Practice Address - Street 1:113 TOPPIN CT
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-1020
Practice Address - Country:US
Practice Address - Phone:919-721-0418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25544101YA0400X
NCP0134931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)