Provider Demographics
NPI:1932242385
Name:REAP, THOMAS GERARD (LMHC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GERARD
Last Name:REAP
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 PATRICIA DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4225
Mailing Address - Country:US
Mailing Address - Phone:315-457-9215
Mailing Address - Fax:315-457-3735
Practice Address - Street 1:117 PATRICIA DR
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-4225
Practice Address - Country:US
Practice Address - Phone:315-457-9215
Practice Address - Fax:315-457-3735
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002568-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health