Provider Demographics
NPI:1811600539
Name:UNALOME INSTITUTE
Entity type:Organization
Organization Name:UNALOME INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:TOCKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PLPC
Authorized Official - Phone:925-337-6920
Mailing Address - Street 1:1266 GLEN EAGLE LN
Mailing Address - Street 2:PO BOX 551
Mailing Address - City:ST. ALBANS
Mailing Address - State:MO
Mailing Address - Zip Code:63073-0551
Mailing Address - Country:US
Mailing Address - Phone:925-337-6920
Mailing Address - Fax:
Practice Address - Street 1:9666 OLIVE BLVD STE 370
Practice Address - Street 2:
Practice Address - City:OLIVETTE
Practice Address - State:MO
Practice Address - Zip Code:63132-3025
Practice Address - Country:US
Practice Address - Phone:314-669-5493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty