Provider Demographics
NPI:1588121735
Name:KINCAID, TORA NICOLE (LCMHC)
Entity type:Individual
Prefix:
First Name:TORA
Middle Name:NICOLE
Last Name:KINCAID
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:TORA
Other - Middle Name:NICOLE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:160 S STERLING ST STE 200
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-3486
Mailing Address - Country:US
Mailing Address - Phone:828-764-7549
Mailing Address - Fax:
Practice Address - Street 1:216 N STERLING ST STE E
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-3314
Practice Address - Country:US
Practice Address - Phone:828-764-7549
Practice Address - Fax:828-301-8161
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NCA14659101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCA14659OtherLCMHCA
NC14659OtherLICENSE