Provider Demographics
NPI:1265603666
Name:GARNER, TOWANDA COLEY (MA LCAS)
Entity type:Individual
Prefix:MRS
First Name:TOWANDA
Middle Name:COLEY
Last Name:GARNER
Suffix:
Gender:F
Credentials:MA LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-9300
Mailing Address - Country:US
Mailing Address - Phone:919-235-2948
Mailing Address - Fax:
Practice Address - Street 1:15 NOBLE ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-9300
Practice Address - Country:US
Practice Address - Phone:919-235-2948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1082101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)