Provider Demographics
NPI:1538787502
Name:GOFF, TONYA L (LPC-A, ADC)
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:L
Last Name:GOFF
Suffix:
Gender:F
Credentials:LPC-A, ADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2179 ASHLEY PHOSPHATE RD STE C
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-4180
Mailing Address - Country:US
Mailing Address - Phone:843-718-3168
Mailing Address - Fax:843-414-7948
Practice Address - Street 1:2179 ASHLEY PHOSPHATE RD STE C
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4180
Practice Address - Country:US
Practice Address - Phone:843-718-3168
Practice Address - Fax:843-414-7948
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCADC-2085101YA0400X
SC8685101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)