Doctor Name: | THOMAS EARLEY |
NPI Number: | 1902994486 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | CC9 |
Business Practice Address: | 333 Main Street Canaan, ME - 04929 |
Business Phone Number: | 2074746990 |
Business Fax Number: | 2074748899 |
Mailing Address: | 118 Moosehead Trl, Suite 5 NEWPORT |
State: | ME |
Postal Code: | 049534020 |
Phone Number: | 2073684213 |
Fax Number: | 2073553033 |
NPI Enumeration Date: | 10/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | CC9 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |