Provider Demographics
NPI:1922493279
Name:CORCORAN, TONI
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 KENNEDY DR APT 301
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-3308
Mailing Address - Country:US
Mailing Address - Phone:781-953-7168
Mailing Address - Fax:
Practice Address - Street 1:301 BROADWAY
Practice Address - Street 2:NORTH SUFFOLK MENTAL HEALTH
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2807
Practice Address - Country:US
Practice Address - Phone:857-776-7451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health