Provider Demographics
NPI:1275810715
Name:O'LEARY, THOMAS J III (LPC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:O'LEARY
Suffix:III
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 1:15985 NW SCHENDEL AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-6734
Mailing Address - Country:US
Mailing Address - Phone:503-893-2552
Mailing Address - Fax:
Practice Address - Street 1:15985 NW SCHENDEL AVE STE 230
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-6734
Practice Address - Country:US
Practice Address - Phone:503-893-2552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3432101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional