Provider Demographics
NPI:1114005113
Name:TOY, LISA (PMHCNS-BC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:TOY
Suffix:
Gender:F
Credentials:PMHCNS-BC
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:ECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-BC
Mailing Address - Street 1:1601 CONCORD PIKE STE 66-68
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3612
Mailing Address - Country:US
Mailing Address - Phone:302-295-1088
Mailing Address - Fax:
Practice Address - Street 1:1601 CONCORD PIKE STE 66-68
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3612
Practice Address - Country:US
Practice Address - Phone:302-295-1088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR10294800163W00000X
DEL10028044163W00000X
NJ26NJD014600364SP0808X
DELE0000168364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8965609Medicaid
NJ8965609Medicaid
069422Medicare ID - Type Unspecified