Provider Demographics
NPI:1720646912
Name:MACALIK, THOMAS B (LPC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:B
Last Name:MACALIK
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 1:824 S CROWLEY RD STE 6
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-4303
Mailing Address - Country:US
Mailing Address - Phone:682-207-4824
Mailing Address - Fax:
Practice Address - Street 1:824 S CROWLEY RD STE 6
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-4303
Practice Address - Country:US
Practice Address - Phone:682-207-4824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78094101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional