Provider Demographics
NPI:1841207602
Name:FLAHERTY, THOMAS J (LPC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:FLAHERTY
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 1:6 WHITE HORSE PIKE
Mailing Address - Street 2:STE 1B
Mailing Address - City:HADDON HTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035
Mailing Address - Country:US
Mailing Address - Phone:856-672-1900
Mailing Address - Fax:856-672-9019
Practice Address - Street 1:6 WHITE HORSE PIKE
Practice Address - Street 2:STE 1B
Practice Address - City:HADDON HTS
Practice Address - State:NJ
Practice Address - Zip Code:08035
Practice Address - Country:US
Practice Address - Phone:856-672-1900
Practice Address - Fax:856-672-9019
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00041000101YP2500X
PAPC002305101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
7275364OtherAETNA
2321306000OtherBLUE CROSS