Provider Demographics
NPI:1932406063
Name:SPIVEY, ONDRIA R (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:ONDRIA
Middle Name:R
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 WHEATLEY RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-1204
Mailing Address - Country:US
Mailing Address - Phone:814-656-1031
Mailing Address - Fax:
Practice Address - Street 1:235 HAIRSTON ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-4137
Practice Address - Country:US
Practice Address - Phone:814-656-1031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-25
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN1720101YM0800X
TNLPC1720101YP2500X
TNLPC0000001720101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNLPC1720OtherSTATE OF TN BOARD FOR LICENSED PROFESSIONAL COUNSELORS