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General NPI Number Information
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NPI Number | 1881893105
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Entity Type | Individual
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Provider Name | THOMAS M. GREANEY LADC, LCDP
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Gender | Male
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 260 S FRONTAGE RD STE 204
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City | NEW LONDON
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State | CT
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Zip | 06320-2637
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Country | US
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Telephone | 860-912-2944
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2504
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City | WESTERLY
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State | RI
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Zip | 02891-0925
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Country | US
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Telephone | 860-912-2944
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 382
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 629
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License Number State | CT
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