Healthcare Provider Details

I. General information

NPI: 1134809411
Provider Name (Legal Business Name): TONYA MARIE ANDREWS PLPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6858 SWINNEA RD BLDG 3B
SOUTHAVEN MS
38671-9493
US

IV. Provider business mailing address

6858 SWINNEA RD BLDG 3B
SOUTHAVEN MS
38671-9493
US

V. Phone/Fax

Practice location:
  • Phone: 662-205-0567
  • Fax: 662-856-4746
Mailing address:
  • Phone: 662-205-0567
  • Fax: 662-856-4647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberP-0935
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP-0935
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: