Doctor Name: | MR. THOMAS MICHAEL VASSAR |
NPI Number: | 1225237746 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | 4704 |
Business Practice Address: | 143 Shaker Rd East Longmeadow, MA - 010282786 |
Business Phone Number: | 4135251711 |
Business Fax Number: | 4137466781 |
Mailing Address: | 143 Shaker Rd, EAST LONGMEADOW |
State: | MA |
Postal Code: | 010282786 |
Phone Number: | 4135251711 |
Fax Number: | 4137466781 |
NPI Enumeration Date: | 07/13/2007 |
NPI Last Update Date: | 07/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 4704 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |