Provider Demographics
NPI:1245538016
Name:MCCLUSKEY, THOMAS (LMSW)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:MCCLUSKEY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7042 ELMWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142
Mailing Address - Country:US
Mailing Address - Phone:215-937-0700
Mailing Address - Fax:215-937-0164
Practice Address - Street 1:7042 ELMWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142
Practice Address - Country:US
Practice Address - Phone:215-937-0700
Practice Address - Fax:215-937-0164
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW128417104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker