Provider Demographics
NPI:1235299041
Name:THOMAS B. MCHENRY PC
Entity Type:Organization
Organization Name:THOMAS B. MCHENRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:MCHENRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:765-463-6716
Mailing Address - Street 1:1011 OAKHURST DR
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE BRA
Mailing Address - State:IN
Mailing Address - Zip Code:47906-2213
Mailing Address - Country:US
Mailing Address - Phone:765-463-6716
Mailing Address - Fax:
Practice Address - Street 1:255 E SUNSET LN
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE BRA
Practice Address - State:IN
Practice Address - Zip Code:47906-2456
Practice Address - Country:US
Practice Address - Phone:765-404-6583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN19110052A103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty