Provider Demographics
NPI:1841548005
Name:HYLAND, THOMAS JOSEPH (MA PC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JOSEPH
Last Name:HYLAND
Suffix:
Gender:M
Credentials:MA PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 S OTTERBEIN AVE
Mailing Address - Street 2:SUITE #9
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2951
Mailing Address - Country:US
Mailing Address - Phone:614-776-5311
Mailing Address - Fax:614-776-5333
Practice Address - Street 1:509 S OTTERBEIN AVE
Practice Address - Street 2:SUITE #9
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2951
Practice Address - Country:US
Practice Address - Phone:614-776-5311
Practice Address - Fax:614-776-5333
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC 1000488101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional