Tonya Iliah Witherspoon, LPC, CSAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6978-125 Issued in WI

Practice address

1320 Wisconsin Ave
Racine, WI 53403-1978

Phone

(262) 687-2222

NPI assigned

Dec 18, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1790257525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 WISCONSIN AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031978",
            "telephone_number": "262-687-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 WISCONSIN AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534031978",
            "telephone_number": "262-687-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERSPOON",
        "first_name": "TONYA",
        "middle_name": "ILIAH",
        "credential": "LPC, CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16327-132",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6978-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Racine, WI
• Providers in Racine, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.