Provider Demographics
NPI:1457364440
Name:CANALE, THOMAS ANTHONY (MSW LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ANTHONY
Last Name:CANALE
Suffix:
Gender:M
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 LEROY STREET
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-4603
Mailing Address - Country:US
Mailing Address - Phone:607-765-9259
Mailing Address - Fax:607-724-3865
Practice Address - Street 1:14 LEROY ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4603
Practice Address - Country:US
Practice Address - Phone:607-765-9259
Practice Address - Fax:607-724-3865
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0380681103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
10951BMedicare ID - Type Unspecified