Allen, Thomas M

Allen, Thomas M is an sole proprietor health care provider with primary practice located at 1700 Lincolnway Pl Ste 8 , La Porte IN 46350-3194. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Health Service, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Health Service is his primary health care specialty. Allen, Thomas M can be contacted via phone (219) 898-5645.

Contact Information

Primary practice address
1700 Lincolnway Pl Ste 8 La Porte IN 46350-3194
Phone: (219) 898-5645
Fax: (219) 325-0855
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Health Service 103TH0100X 071.007397 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X 20042166A Indiana
Behavioral Health & Social Service Providers / Health Service 103TH0100X 20042166A Indiana
Behavioral Health & Social Service Providers / Health Service 103TH0100X 20042166 Indiana

Profile Details

NPI number 1972592798
LBN Legal business name Allen, Thomas M
Credentials PSYD, HSPP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 14th, 2005
Last updated Jun 30th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972592798 NPPES
Indiana MEDICAID 200882550A

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