Provider Demographics
NPI:1285961425
Name:FLAHERTY, THOMAS E (LMHC LMSW)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:E
Last Name:FLAHERTY
Suffix:
Gender:M
Credentials:LMHC LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 MOUNT LORETTA AVE
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-7826
Mailing Address - Country:US
Mailing Address - Phone:563-588-0558
Mailing Address - Fax:641-423-2221
Practice Address - Street 1:600 1ST ST NW STE 105
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2932
Practice Address - Country:US
Practice Address - Phone:641-424-9683
Practice Address - Fax:641-423-2221
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00061101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health