Provider Demographics
NPI:1659327351
Name:TOOLEY, JAMES E (LICSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:TOOLEY
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WELBY RD
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-1137
Mailing Address - Country:US
Mailing Address - Phone:508-998-1115
Mailing Address - Fax:508-998-1140
Practice Address - Street 1:1 WELBY RD
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-1137
Practice Address - Country:US
Practice Address - Phone:508-998-1115
Practice Address - Fax:508-998-1140
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1021421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1853848Medicaid
MAPO 1107Medicare ID - Type Unspecified