Provider Demographics
NPI:1659503027
Name:SILER, TONI LYN (LCSW)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:LYN
Last Name:SILER
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 1:101 WHITSELL WAY
Mailing Address - Street 2:APT 102
Mailing Address - City:PONTOON BEACH
Mailing Address - State:IL
Mailing Address - Zip Code:62040
Mailing Address - Country:US
Mailing Address - Phone:618-960-6145
Mailing Address - Fax:
Practice Address - Street 1:101 WHITSELL WAY
Practice Address - Street 2:APT 102
Practice Address - City:PONTOON BEACH
Practice Address - State:IL
Practice Address - Zip Code:62040
Practice Address - Country:US
Practice Address - Phone:618-960-6145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL17124101YA0400X
IL1490116691041C0700X
MO20060067121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)