Healthcare Provider Details

I. General information

NPI: 1841207602
Provider Name (Legal Business Name): THOMAS J FLAHERTY LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 WHITE HORSE PIKE STE 1B
HADDON HTS NJ
08035
US

IV. Provider business mailing address

6 WHITE HORSE PIKE STE 1B
HADDON HTS NJ
08035
US

V. Phone/Fax

Practice location:
  • Phone: 856-672-1900
  • Fax: 856-672-9019
Mailing address:
  • Phone: 856-672-1900
  • Fax: 856-672-9019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC00041000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC002305
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: