Provider Demographics
NPI:1043281363
Name:TOBOROWSKY, JOAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:
Last Name:TOBOROWSKY
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 1:2026 NAUDAIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1317
Mailing Address - Country:US
Mailing Address - Phone:215-545-3315
Mailing Address - Fax:
Practice Address - Street 1:1062 LANCASTER AVE.
Practice Address - Street 2:SUITE 23A
Practice Address - City:ROSEMONT
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:610-526-9002
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW006840L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS61047Medicare UPIN