Provider Demographics
NPI:1285708842
Name:KASPER, TONIA CARROLL (LCSW, RPT)
Entity type:Individual
Prefix:
First Name:TONIA
Middle Name:CARROLL
Last Name:KASPER
Suffix:
Gender:F
Credentials:LCSW, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 E LAMPKIN ST
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-2909
Mailing Address - Country:US
Mailing Address - Phone:662-418-0692
Mailing Address - Fax:
Practice Address - Street 1:111 CEDAR LN
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2617
Practice Address - Country:US
Practice Address - Phone:662-418-0692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC57671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical