Provider Demographics
NPI:1093179608
Name:MCCAFFREY, THOMAS (BCBA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:MCCAFFREY
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 MANOR CT
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-9243
Mailing Address - Country:US
Mailing Address - Phone:814-931-3503
Mailing Address - Fax:
Practice Address - Street 1:104 MANOR CT
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-9243
Practice Address - Country:US
Practice Address - Phone:814-931-3503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-09
Last Update Date:2016-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002337103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst