Provider Demographics
NPI:1861699514
Name:KOLB, TONI-MARIE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:TONI-MARIE
Middle Name:
Last Name:KOLB
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11571-0074
Mailing Address - Country:US
Mailing Address - Phone:516-299-5373
Mailing Address - Fax:516-299-5293
Practice Address - Street 1:480 OLD WESTBURY RD
Practice Address - Street 2:NORTH SHORE CHILD & FAMILY GUIDANCE CENTER
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2215
Practice Address - Country:US
Practice Address - Phone:516-299-5373
Practice Address - Fax:516-299-5293
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06817411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical