Provider Demographics
NPI:1306439005
Name:SPINKS, TY'KEI (MA, LCMHC-A)
Entity type:Individual
Prefix:
First Name:TY'KEI
Middle Name:
Last Name:SPINKS
Suffix:
Gender:M
Credentials:MA, LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6011 LAKE FOREST RD E APT 206
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-1079
Mailing Address - Country:US
Mailing Address - Phone:336-303-2461
Mailing Address - Fax:
Practice Address - Street 1:5820 E WT HARRIS BLVD STE 205
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-4032
Practice Address - Country:US
Practice Address - Phone:704-469-1243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-15
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional