Provider Demographics
NPI:1821210790
Name:GROSSMAN, TOBY DIAMOND (LPC)
Entity Type:Individual
Prefix:MS
First Name:TOBY
Middle Name:DIAMOND
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 WINDSOR DRIVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739
Mailing Address - Country:US
Mailing Address - Phone:732-842-8415
Mailing Address - Fax:
Practice Address - Street 1:121 AUTH AVENUE
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755
Practice Address - Country:US
Practice Address - Phone:732-517-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00047800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health