Provider Demographics
NPI:1245491703
Name:RYDER, TONI (LCSW)
Entity type:Individual
Prefix:MS
First Name:TONI
Middle Name:
Last Name:RYDER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ANTONIA
Other - Middle Name:
Other - Last Name:RYDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 182
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10959-0182
Mailing Address - Country:US
Mailing Address - Phone:845-216-4511
Mailing Address - Fax:
Practice Address - Street 1:28 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-1639
Practice Address - Country:US
Practice Address - Phone:845-216-4511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07144711101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health