Provider Demographics
NPI:1386725448
Name:WATERHOUSE, THOMAS (LMHC, PA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:WATERHOUSE
Suffix:
Gender:M
Credentials:LMHC, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 CURLEW RD
Mailing Address - Street 2:SUITE 171
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-1901
Mailing Address - Country:US
Mailing Address - Phone:727-784-8223
Mailing Address - Fax:
Practice Address - Street 1:2843 ALTERNATE 19
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34683
Practice Address - Country:US
Practice Address - Phone:727-784-8223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH-772101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health