Provider Demographics
NPI:1649783036
Name:EPPERSON, TONI (LISW-S)
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:
Last Name:EPPERSON
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 BELLEVUE RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-3902
Mailing Address - Country:US
Mailing Address - Phone:567-322-7358
Mailing Address - Fax:
Practice Address - Street 1:3454 OAK ALLEY CT STE 404
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1355
Practice Address - Country:US
Practice Address - Phone:567-318-0944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0305692Medicaid