National Provider Identifier

Thomas John Durham, LCSW-R

Thomas John Durham, LCSW-R is listed in the NPPES registry with a primary specialty of Clinical Social Worker in Canandaigua, NY and a listed phone number of (585) 703-8942.

NPI 1639454101Canandaigua, NYClinical Social Worker

Profile Overview

NPI
1639454101
Provider Type
Individual
Primary Specialty
Clinical Social Worker
Enumeration Date
October 17, 2011
Last Updated
October 17, 2011

Practice Location

  • 18 Douglas Dr
  • Canandaigua, NY 14424-1018

Phone: (585) 703-8942

Specialties

  • Clinical Social Worker (1041C0700X)
Full Record
NPI
1639454101
Entity Type
Individual
Last Name
Durham
First Name
Thomas
Middle Name
John
Name Prefix
Mr.
Credential
LCSW-R
Mailing Street Address
18 Douglas Dr
Mailing City
Canandaigua
Mailing State
NY
Mailing ZIP Code
14424-1018
Mailing Country
US
Mailing Phone
(585) 703-8942
Practice Street Address
18 Douglas Dr
Practice City
Canandaigua
Practice State
NY
Practice ZIP Code
14424-1018
Practice Country
US
Practice Phone
(585) 703-8942
Enumeration Date
October 17, 2011
Last Updated
October 17, 2011
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Social Worker (1041C0700X)