Provider Demographics
NPI:1215237250
Name:GANELES, TOBY (LCSW)
Entity type:Individual
Prefix:MS
First Name:TOBY
Middle Name:
Last Name:GANELES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TOVA
Other - Middle Name:
Other - Last Name:GANELES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:775 BROOKLYN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2948
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:775 BROOKLYN AVE
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-2948
Practice Address - Country:US
Practice Address - Phone:516-331-1521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081045-011041C0700X
NY080851-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical