Provider Demographics
NPI:1073502498
Name:TOOLEY, CONSTANCE J (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:J
Last Name:TOOLEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3296 TECUMSEH WAY
Mailing Address - Street 2:
Mailing Address - City:BARGERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46106-8468
Mailing Address - Country:US
Mailing Address - Phone:317-535-9400
Mailing Address - Fax:
Practice Address - Street 1:494 S EMERSON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1912
Practice Address - Country:US
Practice Address - Phone:317-888-0581
Practice Address - Fax:317-888-6221
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000039A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health