Provider Demographics
NPI:1407065048
Name:SABELLICO, THOMAS (LMFT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:SABELLICO
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:CT
Mailing Address - Zip Code:06525-1645
Mailing Address - Country:US
Mailing Address - Phone:203-389-5363
Mailing Address - Fax:
Practice Address - Street 1:12 OVERLOOK RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:CT
Practice Address - Zip Code:06525-1645
Practice Address - Country:US
Practice Address - Phone:203-389-5363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT419106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist