Healthcare Provider Details

I. General information

NPI: 1659280923
Provider Name (Legal Business Name): TOLAYAH STANCIL LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

946 W ANDREWS AVE STE R
HENDERSON NC
27536-2500
US

IV. Provider business mailing address

946 W ANDREWS AVE STE R
HENDERSON NC
27536-2500
US

V. Phone/Fax

Practice location:
  • Phone: 252-598-2462
  • Fax: 252-598-0956
Mailing address:
  • Phone: 252-598-2462
  • Fax: 252-598-0956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: