1851564926 NPI number — ELIZABETH TOLEDO LCSW

Table of content: ELIZABETH TOLEDO LCSW (NPI 1851564926)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851564926 NPI number — ELIZABETH TOLEDO LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOLEDO
Provider First Name:
ELIZABETH
Provider Middle Name:
Provider Name Prefix Text:
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:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1851564926
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/01/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3765 TETON PASS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELLENWOOD
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30294-6653
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-312-6531
Provider Business Mailing Address Fax Number:
423-822-5729

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
716 HOLCOMB BRIDGE RD
Provider Second Line Business Practice Location Address:
FL 2
Provider Business Practice Location Address City Name:
NORCROSS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30071-1325
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-363-7890
Provider Business Practice Location Address Fax Number:
404-363-3923
Provider Enumeration Date:
04/09/2008

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: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: CSW004248 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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