Provider Demographics
NPI:1821145004
Name:TOLEDO, ROBERTO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:
Last Name:TOLEDO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 FELLER DR
Mailing Address - Street 2:
Mailing Address - City:CENTRAL ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11722-1213
Mailing Address - Country:US
Mailing Address - Phone:631-334-4299
Mailing Address - Fax:
Practice Address - Street 1:376 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-2854
Practice Address - Country:US
Practice Address - Phone:631-334-4299
Practice Address - Fax:866-422-9552
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075458-11041C0700X
NY068017-1104100000X
LA171581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker