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General NPI Number Information
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NPI Number | 1467637728
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Entity Type | Individual
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Provider Name | HONTAH TENEA EPPS LCSW, MSW
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Gender | Female
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 1408 TRAVERTINE TER
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City | SANFORD
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State | FL
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Zip | 32771-3697
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Country | US
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Telephone | 704-904-8312
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Fax |
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Provider Business Mailing Address
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Address Line | 1408 TRAVERTINE TER
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City | SANFORD
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State | FL
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Zip | 32771-3697
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Country | US
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Telephone | 704-904-8312
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12487
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C006092
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW21195
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License Number State | FL
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