Provider Demographics
NPI:1417014390
Name:THOMAS J. PLAHOVINSAK, INC.
Entity Type:Organization
Organization Name:THOMAS J. PLAHOVINSAK, INC.
Other - Org Name:COMMUNITY PSYCHOLOGY ASSOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:PLAHOVINSAK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:732-240-1617
Mailing Address - Street 1:448 LAKEHURST RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6380
Mailing Address - Country:US
Mailing Address - Phone:732-240-1617
Mailing Address - Fax:732-341-0757
Practice Address - Street 1:448 LAKEHURST RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6380
Practice Address - Country:US
Practice Address - Phone:732-240-1617
Practice Address - Fax:732-341-0757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00321800101YP2500X
NJ2796103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ094867Medicare PIN