Provider Demographics
NPI:1518095967
Name:CORDIER, THOMAS ANDREW I (MALPC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ANDREW
Last Name:CORDIER
Suffix:I
Gender:M
Credentials:MALPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NEW ENGLAND BEHAVIORAL HEALTH
Mailing Address - Street 2:2389 MAIN STREET
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-4617
Mailing Address - Country:US
Mailing Address - Phone:860-659-6551
Mailing Address - Fax:860-499-5010
Practice Address - Street 1:NEW ENGLAND BEHAVIORAL HEALTH
Practice Address - Street 2:2389 MAIN STREET
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4617
Practice Address - Country:US
Practice Address - Phone:860-659-6551
Practice Address - Fax:860-499-5010
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001420101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health