Provider Demographics
NPI:1508646464
Name:THOMAS M. PICA, INC.
Entity Type:Organization
Organization Name:THOMAS M. PICA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:PICA
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CASAC-2
Authorized Official - Phone:631-923-7431
Mailing Address - Street 1:203 SMITH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-1150
Mailing Address - Country:US
Mailing Address - Phone:631-923-7431
Mailing Address - Fax:
Practice Address - Street 1:203 SMITH AVE
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-1150
Practice Address - Country:US
Practice Address - Phone:631-923-7431
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty