Provider Demographics
NPI:1992742878
Name:WEBSTER, TONIA (PHD, LPC, FLP)
Entity type:Individual
Prefix:
First Name:TONIA
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:PHD, LPC, FLP
Other - Prefix:
Other - First Name:TONIA
Other - Middle Name:
Other - Last Name:SIVYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, FLP
Mailing Address - Street 1:PO BOX 94
Mailing Address - Street 2:
Mailing Address - City:MULLIKEN
Mailing Address - State:MI
Mailing Address - Zip Code:48861-0094
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5527 LAWRENCE HWY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-9549
Practice Address - Country:US
Practice Address - Phone:517-896-6938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009371103T00000X
MI6301014767103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist