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General NPI Number Information
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NPI Number | 1053671925
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Entity Type | Individual
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Provider Name | THOMAS JAMES MCCAFFREY
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Gender | Male
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Dates
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Enumeration Date | 05/24/2012
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Last Update Date | 06/21/2019
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Provider Practice Location Address
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Address Line | 1925 ASPEN DR STE 901B
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City | SANTA FE
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State | NM
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Zip | 87505-5569
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Country | US
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Telephone | 847-471-6993
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 ASPEN DR STE 901B
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City | SANTA FE
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State | NM
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Zip | 87505-5569
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1422
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License Number State | NM
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