Provider Demographics
NPI:1700385432
Name:CAFFERY, THOMAS P (LPCC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
Last Name:CAFFERY
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8205 SPAIN RD NE STE 106
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3155
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8205 SPAIN RD NE STE 106
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3155
Practice Address - Country:US
Practice Address - Phone:505-856-0300
Practice Address - Fax:505-856-7946
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMH0194381101YM0800X
NMCCMH0203081101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health