Healthcare Provider Details

I. General information

NPI: 1194603167
Provider Name (Legal Business Name): TOYA S NORTHINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 MEDLEY CT
VINE GROVE KY
40175-8421
US

IV. Provider business mailing address

103 ROYAL CT
NEW ALBANY IN
47150-6647
US

V. Phone/Fax

Practice location:
  • Phone: 270-352-1133
  • Fax: 270-352-1131
Mailing address:
  • Phone: 404-587-2651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number260478
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: