Provider Demographics
NPI:1952625535
Name:TOLSON, MANDY ALLYSON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:ALLYSON
Last Name:TOLSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MILL PLAIN RD
Mailing Address - Street 2:SUITE 312
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-5181
Mailing Address - Country:US
Mailing Address - Phone:203-798-0888
Mailing Address - Fax:203-744-5550
Practice Address - Street 1:170 TAUNTON HILL RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1723
Practice Address - Country:US
Practice Address - Phone:203-426-4849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0047291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical