Provider Demographics
NPI:1588231153
Name:KING-TOLER, ERICA LYNNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:LYNNE
Last Name:KING-TOLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 RIVERSIDE DR APT 15O
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-7222
Mailing Address - Country:US
Mailing Address - Phone:917-796-3084
Mailing Address - Fax:
Practice Address - Street 1:626 RIVERSIDE DR APT 15O
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-7222
Practice Address - Country:US
Practice Address - Phone:917-796-3084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04656103TC1900X
NY017580103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling