Provider Demographics
NPI:1700994639
Name:KING, THOMAS WILLIAM (LPC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:KING
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 PALMER RD
Mailing Address - Street 2:
Mailing Address - City:CHAPLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06235-2318
Mailing Address - Country:US
Mailing Address - Phone:860-455-1991
Mailing Address - Fax:
Practice Address - Street 1:71 HAYNES ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4131
Practice Address - Country:US
Practice Address - Phone:860-646-1222
Practice Address - Fax:860-647-6809
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional