Provider Demographics
NPI:1538522248
Name:DOYLE, THOMAS (MS,PHD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:DOYLE
Suffix:
Gender:M
Credentials:MS,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 COUNTY ROUTE 14
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13680-3104
Mailing Address - Country:US
Mailing Address - Phone:315-344-7358
Mailing Address - Fax:
Practice Address - Street 1:1201 COUNTY ROUTE 14
Practice Address - Street 2:
Practice Address - City:RENSSELAER FALLS
Practice Address - State:NY
Practice Address - Zip Code:13680-3104
Practice Address - Country:US
Practice Address - Phone:315-344-7358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003753-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health