Provider Demographics
NPI:1326306572
Name:LORIO, THOMAS J (LCSW)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:LORIO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 43RD AVE
Mailing Address - Street 2:APT E 25
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-2551
Mailing Address - Country:US
Mailing Address - Phone:914-564-1824
Mailing Address - Fax:646-764-6404
Practice Address - Street 1:4215 43RD AVE
Practice Address - Street 2:APT E 25
Practice Address - City:SUNNYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11104-2551
Practice Address - Country:US
Practice Address - Phone:914-564-1824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0747821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00244019Medicaid