Provider Demographics
NPI:1730981994
Name:PERRY, THOMAS CHRISTOPHER (CASAC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:CHRISTOPHER
Last Name:PERRY
Suffix:
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ATHOL ST
Mailing Address - Street 2:
Mailing Address - City:ISLIP TERRACE
Mailing Address - State:NY
Mailing Address - Zip Code:11752-1601
Mailing Address - Country:US
Mailing Address - Phone:203-410-8626
Mailing Address - Fax:
Practice Address - Street 1:25 AVENUE D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-6935
Practice Address - Country:US
Practice Address - Phone:646-395-4207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9991101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)