Provider Demographics
NPI:1801985692
Name:TOY, THOMAS BRUCE (PHD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:BRUCE
Last Name:TOY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 PINEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-2564
Mailing Address - Country:US
Mailing Address - Phone:919-851-7999
Mailing Address - Fax:
Practice Address - Street 1:1621 PINEVIEW DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2564
Practice Address - Country:US
Practice Address - Phone:919-851-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0421103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC04886OtherBLUE SHIELD PROVIDER NUMB
NC2812397Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER