Provider Demographics
NPI:1851653067
Name:LONEY, THOMAS E (MA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:LONEY
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 COLUMBUS ST APT 1
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-1444
Mailing Address - Country:US
Mailing Address - Phone:641-204-1505
Mailing Address - Fax:
Practice Address - Street 1:1208 COLUMBUS ST APT 1
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1444
Practice Address - Country:US
Practice Address - Phone:641-204-1505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001516101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health