Provider Demographics
NPI:1205841608
Name:TONELLI, GRAZIA (LCSW R)
Entity Type:Individual
Prefix:MRS
First Name:GRAZIA
Middle Name:
Last Name:TONELLI
Suffix:
Gender:F
Credentials:LCSW R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BINGHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905
Mailing Address - Country:US
Mailing Address - Phone:607-724-2245
Mailing Address - Fax:
Practice Address - Street 1:38 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BINGHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:13905
Practice Address - Country:US
Practice Address - Phone:607-724-2245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR02367511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCC7181Medicare PIN