Provider Demographics
NPI:1851564926
Name:TOLEDO, ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:TOLEDO
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 1:3765 TETON PASS
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-6653
Mailing Address - Country:US
Mailing Address - Phone:404-312-6531
Mailing Address - Fax:423-822-5729
Practice Address - Street 1:716 HOLCOMB BRIDGE RD
Practice Address - Street 2:FL 2
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-1325
Practice Address - Country:US
Practice Address - Phone:404-363-7890
Practice Address - Fax:404-363-3923
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
GACSW0042481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health