Provider Demographics
NPI:1366774663
Name:TOOLE, MARIE LYNN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:LYNN
Last Name:TOOLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIE
Other - Middle Name:LYNN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:500 RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-3632
Mailing Address - Country:US
Mailing Address - Phone:262-548-7263
Mailing Address - Fax:
Practice Address - Street 1:500 RIVERVIEW AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3632
Practice Address - Country:US
Practice Address - Phone:262-548-7263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-11
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7102-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical