Provider Demographics
NPI:1861622870
Name:CALLAHAN, THOMAS PATRICK (PHD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:PATRICK
Last Name:CALLAHAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 FREEBODY ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-5504
Mailing Address - Country:US
Mailing Address - Phone:401-845-6682
Mailing Address - Fax:401-845-9095
Practice Address - Street 1:8 FREEBODY ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02840-5504
Practice Address - Country:US
Practice Address - Phone:401-845-6682
Practice Address - Fax:401-845-9095
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool