Provider Demographics
NPI:1164409777
Name:MCCABE JR, THOMAS JAMES JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JAMES
Last Name:MCCABE JR
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5912 S CODY ST STE 107
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-9541
Mailing Address - Country:US
Mailing Address - Phone:720-243-3071
Mailing Address - Fax:303-862-5593
Practice Address - Street 1:5912 S CODY ST STE 107
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-9541
Practice Address - Country:US
Practice Address - Phone:720-243-3071
Practice Address - Fax:303-862-5593
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19263101YP2500X
CO5334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170758001Medicaid
CO09376577Medicaid