Healthcare Provider Details

I. General information

NPI: 1821903873
Provider Name (Legal Business Name): TONDELYNIA DANIELS LCASA, LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N JAMES ST
GOLDSBORO NC
27530-3629
US

IV. Provider business mailing address

414 ADLER LN
GOLDSBORO NC
27530-5520
US

V. Phone/Fax

Practice location:
  • Phone: 919-330-4576
  • Fax: 919-400-4236
Mailing address:
  • Phone: 252-367-8067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number31874
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23608
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: