Provider Demographics
NPI:1457585184
Name:DEMATO, TONI ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TONI
Middle Name:ANN
Last Name:DEMATO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 GREENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-2423
Mailing Address - Country:US
Mailing Address - Phone:203-994-0256
Mailing Address - Fax:
Practice Address - Street 1:241 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2423
Practice Address - Country:US
Practice Address - Phone:203-994-0256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-10
Last Update Date:2009-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0064771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical