Provider Demographics
NPI:1588748867
Name:TOTH, JAMES MICHAEL (PSYD, HSPP)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:TOTH
Suffix:
Gender:M
Credentials:PSYD, HSPP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:110 W ENT AVE BLDG 725
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1595
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3768 ROME DRIVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905
Practice Address - Country:US
Practice Address - Phone:765-449-9115
Practice Address - Fax:765-446-4224
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COPSY.0005068103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN070930NMedicare ID - Type Unspecified