Provider Demographics
NPI:1841571460
Name:STOCKEL, ILENE TOLEDO (PSY)
Entity type:Individual
Prefix:DR
First Name:ILENE
Middle Name:TOLEDO
Last Name:STOCKEL
Suffix:
Gender:F
Credentials:PSY
Other - Prefix:DR
Other - First Name:ILENE
Other - Middle Name:TOLEDO
Other - Last Name:STOCKEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSY
Mailing Address - Street 1:10 STEWART PL
Mailing Address - Street 2:2EW
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-3800
Mailing Address - Country:US
Mailing Address - Phone:914-772-6900
Mailing Address - Fax:845-426-1124
Practice Address - Street 1:10 STEWART PL
Practice Address - Street 2:2EW
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-3800
Practice Address - Country:US
Practice Address - Phone:914-772-6900
Practice Address - Fax:845-426-1124
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011807-1103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent