Provider Demographics
NPI:1821366899
Name:KAUFMAN, THOMAS MICHAEL (LPC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MICHAEL
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7818 BIG SKY DR
Mailing Address - Street 2:#101
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-3524
Mailing Address - Country:US
Mailing Address - Phone:608-203-6267
Mailing Address - Fax:
Practice Address - Street 1:7818 BIG SKY DR
Practice Address - Street 2:#101
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-3524
Practice Address - Country:US
Practice Address - Phone:608-203-6267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5311-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional