MEDICARE: TONYA WILLIS MA; LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	92403	TX

General Provider Information

NPI Number	:	1104601103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA WILLIS MA; LPC

Provider Business Mailing Address
First Line	:	212 N HILLSIDE ST
Second Line	:
City	:	RED OAK
State	:	TX
Zip	:	75154-6314
Country	:	US
Telephone Number	:	214-200-5781
Fax Number	:

Provider Business Practice Location Address
First Line	:	1721 W PLANO PKWY STE 216
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-8600
Country	:	US
Telephone Number	:	214-200-5781
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2023
Last Update Date	:	12/11/2025

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Directions to “ TONYA WILLIS MA; LPC” Practice Location

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