Individual provider Active NPI

Shanee Toledano, PHD

  • Psychologist
  • Dunwoody, GA
National Provider Identifier
1700301751
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PSY004117 Issued in GA
Practice address
1360 Center Dr Ste 200
Dunwoody, GA 30338-4135
Phone
(678) 825-2320
NPI assigned
Aug 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PSY004117 GA Primary

Addresses

Primary practice location

1360 Center Dr Ste 200
Dunwoody, GA 30338-4135

Mailing address

1360 Center Dr Ste 200
Dunwoody, GA 30338-4135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Aug 27, 2024 through Aug 27, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY004117GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anxiety Specialists of Atlanta LLC CurrentSince Sep 23, 2024 Accepting new patients
Soublis Psychological Associates, LLC Past Accepting new patients

Locations

1360 Center Dr
Ste 200
Dunwoody, GA 30338
Phone (678) 825-2320

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1700301751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 CENTER DR STE 200",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303384135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 CENTER DR STE 200",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303384135",
            "telephone_number": "678-825-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLEDANO",
        "first_name": "SHANEE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

Sources for this page

Verify at the official NPI Registry.