Provider Demographics
NPI:1003331943
Name:DOOLEY, THOMAS WILSON (MS,LPC, CRC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:WILSON
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:MS,LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 WALKER RD NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-2663
Mailing Address - Country:US
Mailing Address - Phone:503-551-9723
Mailing Address - Fax:
Practice Address - Street 1:1515 LIBERTY ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4345
Practice Address - Country:US
Practice Address - Phone:503-951-6280
Practice Address - Fax:503-468-3130
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR4295101YM0800X
ORC6595101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health