Provider Demographics
NPI:1295437218
Name:TOOTLE, ABEL TIMOTHY JR (MSS, MLSP, GC-C)
Entity type:Individual
Prefix:MR
First Name:ABEL
Middle Name:TIMOTHY
Last Name:TOOTLE
Suffix:JR
Gender:M
Credentials:MSS, MLSP, GC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-2004
Mailing Address - Country:US
Mailing Address - Phone:215-978-1300
Mailing Address - Fax:215-689-1518
Practice Address - Street 1:827 N. 23RD STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123
Practice Address - Country:US
Practice Address - Phone:215-978-1300
Practice Address - Fax:215-689-1518
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical