Provider Demographics
NPI:1447857917
Name:TORO, JUSTIN M (LMSW)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:M
Last Name:TORO
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3908 BRONX BLVD APT 5D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-3547
Mailing Address - Country:US
Mailing Address - Phone:347-813-3443
Mailing Address - Fax:
Practice Address - Street 1:3230 BAINBRIDGE AVE STE D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-3963
Practice Address - Country:US
Practice Address - Phone:718-882-5482
Practice Address - Fax:718-882-5725
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093672-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical