Provider Demographics
NPI:1083623227
Name:TOLMOFF, NANCY J (LMFT, LPC)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:J
Last Name:TOLMOFF
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-3517
Mailing Address - Country:US
Mailing Address - Phone:203-775-1017
Mailing Address - Fax:203-775-5005
Practice Address - Street 1:31 HIGH RIDGE RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-3517
Practice Address - Country:US
Practice Address - Phone:203-775-1017
Practice Address - Fax:203-775-5005
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTLPC 000923101YP2500X
CTLMFT 000491106H00000X
CT101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT11244919OtherCAQH ID #
CT410000491CT01OtherBCBS ID #
CT000491OtherLMFT LICENSE #
CTNT3074565OtherAPERTURE #
CT000923OtherLIC PROFESSIONALCOUNSELOR
CT071944OtherVALUEOPTIONS ID #