Provider Demographics
NPI:1689715575
Name:TOLMAN, REBECCA J (LMSWCC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:J
Last Name:TOLMAN
Suffix:
Gender:F
Credentials:LMSWCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGVALE
Mailing Address - State:ME
Mailing Address - Zip Code:04083
Mailing Address - Country:US
Mailing Address - Phone:207-324-1500
Mailing Address - Fax:207-282-7509
Practice Address - Street 1:474 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGVALE
Practice Address - State:ME
Practice Address - Zip Code:04083-1409
Practice Address - Country:US
Practice Address - Phone:207-324-1500
Practice Address - Fax:207-282-7509
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC10935101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432510499Medicaid