Provider Demographics
NPI:1427513407
Name:TOSCANO, JOSEPH (NBC, CACIII)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:TOSCANO
Suffix:
Gender:M
Credentials:NBC, CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1304
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:CO
Mailing Address - Zip Code:80540-1304
Mailing Address - Country:US
Mailing Address - Phone:720-210-4535
Mailing Address - Fax:303-823-5756
Practice Address - Street 1:703 WALNUT ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5032
Practice Address - Country:US
Practice Address - Phone:720-210-4535
Practice Address - Fax:303-823-5756
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38199101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor