Provider Demographics
NPI:1871190793
Name:MCCLARY, TOBY (LCSW)
Entity type:Individual
Prefix:
First Name:TOBY
Middle Name:
Last Name:MCCLARY
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:TOBY
Other - Middle Name:
Other - Last Name:FARRENKOPF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:815 37TH AVE S STE 200
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56560-5524
Mailing Address - Country:US
Mailing Address - Phone:701-471-7092
Mailing Address - Fax:701-401-0267
Practice Address - Street 1:815 37TH AVE S STE 200
Practice Address - Street 2:
Practice Address - City:MOORHEAD
Practice Address - State:MN
Practice Address - Zip Code:56560-5524
Practice Address - Country:US
Practice Address - Phone:701-471-7092
Practice Address - Fax:701-401-0267
Is Sole Proprietor?:No
Enumeration Date:2020-10-04
Last Update Date:2025-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND5651104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker