Provider Demographics
NPI:1336785229
Name:PECCA, THOMAS J (LMHC, CSAT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:PECCA
Suffix:
Gender:M
Credentials:LMHC, CSAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34489-0190
Mailing Address - Country:US
Mailing Address - Phone:352-598-8865
Mailing Address - Fax:352-598-8865
Practice Address - Street 1:3230 NE 55TH AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34488-1721
Practice Address - Country:US
Practice Address - Phone:855-483-7800
Practice Address - Fax:352-509-5891
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
FLMH15280101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)