Provider Demographics
NPI:1306966767
Name:DIPAOLA, THOMAS CHARLES (LICENSED CLINICAL SO)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:CHARLES
Last Name:DIPAOLA
Suffix:
Gender:M
Credentials:LICENSED CLINICAL SO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:71 W MAIN ST STE 306
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2139
Mailing Address - Country:US
Mailing Address - Phone:609-731-0456
Mailing Address - Fax:732-252-8612
Practice Address - Street 1:71 W MAIN ST
Practice Address - Street 2:SUITE 306
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-2138
Practice Address - Country:US
Practice Address - Phone:609-731-0456
Practice Address - Fax:732-252-8612
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052742001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical