Provider Demographics
NPI:1598334625
Name:TONEY, LATASHA D (LICSW, PIP)
Entity type:Individual
Prefix:
First Name:LATASHA
Middle Name:D
Last Name:TONEY
Suffix:
Gender:F
Credentials:LICSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:459 MAIN ST # 248
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-1416
Mailing Address - Country:US
Mailing Address - Phone:205-952-6583
Mailing Address - Fax:
Practice Address - Street 1:3516 VANN RD STE 106A
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3276
Practice Address - Country:US
Practice Address - Phone:205-952-6583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3963C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical