Provider Demographics
NPI:1396875092
Name:WADLEIGH, THOMAS HENRY (CMHC, LMHC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:HENRY
Last Name:WADLEIGH
Suffix:
Gender:M
Credentials:CMHC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7804 W STEP MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-3642
Mailing Address - Country:US
Mailing Address - Phone:801-865-6122
Mailing Address - Fax:
Practice Address - Street 1:7804 W STEP MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:HERRIMAN
Practice Address - State:UT
Practice Address - Zip Code:84096-3642
Practice Address - Country:US
Practice Address - Phone:801-865-6122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6248093-6004101YM0800X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health