Provider Demographics
NPI:1225566193
Name:NETHERY, TONI F (MAED, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:TONI
Middle Name:F
Last Name:NETHERY
Suffix:
Gender:F
Credentials:MAED, LPCC
Other - Prefix:MRS
Other - First Name:ANTOINETTE
Other - Middle Name:F
Other - Last Name:NETHERY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MAED, LPCC
Mailing Address - Street 1:414 CARY JAY BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-1728
Mailing Address - Country:US
Mailing Address - Phone:216-233-5216
Mailing Address - Fax:
Practice Address - Street 1:3618 W MARKET ST STE 11
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-2425
Practice Address - Country:US
Practice Address - Phone:216-233-5216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-23
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE1700131101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health