Provider Demographics
NPI:1063927671
Name:TONEY, JAMES
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:TONEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 EASTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-1602
Mailing Address - Country:US
Mailing Address - Phone:270-901-9663
Mailing Address - Fax:270-517-0300
Practice Address - Street 1:624 EASTWOOD ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103
Practice Address - Country:US
Practice Address - Phone:270-901-9663
Practice Address - Fax:270-517-0300
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY175239101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty