Provider Demographics
NPI:1972504876
Name:TONTI, ROBERTA JUDITH (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:JUDITH
Last Name:TONTI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5035 MAYFIELD ROAD
Mailing Address - Street 2:SUITE #214
Mailing Address - City:LYNDHURST
Mailing Address - State:OH
Mailing Address - Zip Code:44124-2603
Mailing Address - Country:US
Mailing Address - Phone:216-371-0046
Mailing Address - Fax:216-321-6351
Practice Address - Street 1:5035 MAYFIELD RD
Practice Address - Street 2:SUITE #214
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2688
Practice Address - Country:US
Practice Address - Phone:216-371-0046
Practice Address - Fax:216-321-6351
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI7461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW02511Medicare ID - Type UnspecifiedSOCIAL WORK