MEDICARE: JUANITA DARLENE TONEY LPC, Q-SAP

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	101YP2500X	Professional Counselor	LPC0000002430	TN
2	101YP2500X	Professional Counselor	LPC005301	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326272998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUANITA DARLENE TONEY LPC, Q-SAP

Provider Business Mailing Address
First Line	:	5818 N PARK RD
Second Line	:
City	:	HIXSON
State	:	TN
Zip	:	37343-4619
Country	:	US
Telephone Number	:	423-874-1993
Fax Number	:	423-874-1993

Provider Business Practice Location Address
First Line	:	747 BATTLEFIELD PKWY
Second Line	:	STE 1458 2B
City	:	FT OGLETHORPE
State	:	GA
Zip	:	30742-3923
Country	:	US
Telephone Number	:	423-322-2360
Fax Number	:	423-874-1993

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

Provider Enumeration Date	:	05/11/2009
Last Update Date	:	12/14/2010

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