Provider Demographics
NPI:1619133386
Name:TOLEN, MARTIN J JR (MSW,LCSW,SSWS)
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:J
Last Name:TOLEN
Suffix:JR
Gender:M
Credentials:MSW,LCSW,SSWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S ROUTE 73
Mailing Address - Street 2:SUITE F
Mailing Address - City:WEST BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08091-2603
Mailing Address - Country:US
Mailing Address - Phone:609-506-6229
Mailing Address - Fax:856-262-8269
Practice Address - Street 1:701 S ROUTE 73
Practice Address - Street 2:SUITE F
Practice Address - City:WEST BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08091-2603
Practice Address - Country:US
Practice Address - Phone:609-506-6229
Practice Address - Fax:856-262-8269
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ-SC-04480101YA0400X, 101YM0800X, 101YP2500X, 101YS0200X, 1041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist