Healthcare Provider Details

I. General information

NPI: 1730078668
Provider Name (Legal Business Name): TONYIA BEHRENDT PROFESSIONAL COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 COMMERCE CENTER LOOP STE D
MOORESVILLE NC
28117-8385
US

IV. Provider business mailing address

114 COMMERCE CENTER LOOP STE D
MOORESVILLE NC
28117-8385
US

V. Phone/Fax

Practice location:
  • Phone: 970-412-5182
  • Fax: 704-412-9286
Mailing address:
  • Phone: 970-412-5182
  • Fax: 704-412-9286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TONYIA BEHRENDT
Title or Position: OWNER
Credential: LCMHC
Phone: 970-412-5182