Provider Demographics
NPI:1861522930
Name:GOREY, THOMAS M (LCPC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:GOREY
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 E MAIN ST STE 214
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3203
Mailing Address - Country:US
Mailing Address - Phone:815-459-4516
Mailing Address - Fax:
Practice Address - Street 1:330 E MAIN ST STE 214
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3203
Practice Address - Country:US
Practice Address - Phone:815-459-4516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007299101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional