Provider Demographics
NPI:1265158851
Name:NICOLETTO, TONI MARIA (LCSW, LISW)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:MARIA
Last Name:NICOLETTO
Suffix:
Gender:F
Credentials:LCSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 W 40TH ST UNIT 2225
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37409-1379
Mailing Address - Country:US
Mailing Address - Phone:877-358-2998
Mailing Address - Fax:
Practice Address - Street 1:400 LOCUST ST
Practice Address - Street 2:SUITE 400
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309
Practice Address - Country:US
Practice Address - Phone:877-358-2998
Practice Address - Fax:423-405-6346
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTPSW23281041C0700X
IL149.0244801041C0700X
IA0955331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical