1215542899 NPI number — MRS. DERNAY TOY COLEY LCSW

Table of content: MRS. DERNAY TOY COLEY LCSW (NPI 1215542899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215542899 NPI number — MRS. DERNAY TOY COLEY LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLEY
Provider First Name:
DERNAY
Provider Middle Name:
TOY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COLEY-TORRES
Provider Other First Name:
DERNAY
Provider Other Middle Name:
TOY
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1215542899
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/24/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4509 ENSENADA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78504-9727
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-620-6319
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1214 W SCHUNIOR ST FL STREET1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDINBURG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78541-2337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-296-1987
Provider Business Practice Location Address Fax Number:
956-358-9225
Provider Enumeration Date:
09/10/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  51732 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)