Provider Demographics
NPI:1629268107
Name:TOMAN, NICHOLAS ALBERT (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:ALBERT
Last Name:TOMAN
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11545 2ND AVENUE OCEAN
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:FL
Mailing Address - Zip Code:33050-3606
Mailing Address - Country:US
Mailing Address - Phone:305-395-2430
Mailing Address - Fax:
Practice Address - Street 1:6400 OVERSEAS HWY
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-2786
Practice Address - Country:US
Practice Address - Phone:305-395-2430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH6139101Y00000X
FLMH 9786101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor