Provider Demographics
NPI:1437531407
Name:SARPY, THADDIEUS (MS, LMHC)
Entity Type:Individual
Prefix:MR
First Name:THADDIEUS
Middle Name:
Last Name:SARPY
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 EASTBROOK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-2083
Mailing Address - Country:US
Mailing Address - Phone:857-293-5020
Mailing Address - Fax:857-226-8772
Practice Address - Street 1:30 EASTBROOK RD STE 101
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-2083
Practice Address - Country:US
Practice Address - Phone:857-293-5020
Practice Address - Fax:857-226-8772
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10941-MH-CC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health