Provider Demographics
NPI:1598733396
Name:CARVER, THOMAS DEVEREUX (MFT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:DEVEREUX
Last Name:CARVER
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 GRANADA ST STE O
Mailing Address - Street 2:SESPE COUNSELING CENTER AND GALLERY
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-7725
Mailing Address - Country:US
Mailing Address - Phone:805-987-3162
Mailing Address - Fax:805-830-1560
Practice Address - Street 1:155 GRANADA ST
Practice Address - Street 2:SUITE O
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-7866
Practice Address - Country:US
Practice Address - Phone:805-987-3162
Practice Address - Fax:805-830-1560
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41948106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist