Provider Demographics
NPI:1518173103
Name:TOONKEL, MIRIAM JUDITH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:JUDITH
Last Name:TOONKEL
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 1:134 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-5602
Mailing Address - Country:US
Mailing Address - Phone:973-696-4016
Mailing Address - Fax:
Practice Address - Street 1:134 CHESTNUT DR
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-5602
Practice Address - Country:US
Practice Address - Phone:973-696-4016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004508001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical