Provider Demographics
NPI:1760039671
Name:TONEY, CASSANDRA (SWT)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:TONEY
Suffix:
Gender:F
Credentials:SWT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 93
Mailing Address - Street 2:
Mailing Address - City:WILKESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45695-0093
Mailing Address - Country:US
Mailing Address - Phone:740-603-2899
Mailing Address - Fax:
Practice Address - Street 1:120 NORTH STREET
Practice Address - Street 2:
Practice Address - City:WILKESVILLE
Practice Address - State:OH
Practice Address - Zip Code:45695-4569
Practice Address - Country:US
Practice Address - Phone:740-603-2899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
OH172A00000X, 376J00000X, 3747P1801X
OHTN334836172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No172A00000XOther Service ProvidersDriver
No376J00000XNursing Service Related ProvidersHomemaker