Provider Demographics
NPI:1396949814
Name:STANFIELD, THOMAS JAY (MA, LMHC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JAY
Last Name:STANFIELD
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2802 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-5898
Mailing Address - Country:US
Mailing Address - Phone:319-268-9700
Mailing Address - Fax:
Practice Address - Street 1:2802 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-5898
Practice Address - Country:US
Practice Address - Phone:319-268-9700
Practice Address - Fax:319-268-1934
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA101295101YM0800X, 101YP2500X
MO2007012424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health