Provider Demographics
NPI:1710235627
Name:TOLAND, MICHELLE L (LCSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:TOLAND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 LIBERTY ST SW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-2715
Mailing Address - Country:US
Mailing Address - Phone:804-207-6737
Mailing Address - Fax:804-730-2829
Practice Address - Street 1:199 LIBERTY ST SW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-2715
Practice Address - Country:US
Practice Address - Phone:804-207-6737
Practice Address - Fax:804-730-2829
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040129341041C0700X
PACW0244211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical