Provider Demographics
NPI:1619196821
Name:TATROE, TONYA GAYLE (LPC)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:GAYLE
Last Name:TATROE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:GAYLE
Other - Last Name:GRISSOM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:305 OSCEOLA CT
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-3703
Mailing Address - Country:US
Mailing Address - Phone:870-919-6585
Mailing Address - Fax:
Practice Address - Street 1:103 W FLEEMAN
Practice Address - Street 2:
Practice Address - City:MANILA
Practice Address - State:AR
Practice Address - Zip Code:72442-0835
Practice Address - Country:US
Practice Address - Phone:870-919-6585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0907044101YP2500X
ARA0703029101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor