Basic Information
| Provider Information | |||||||||
| NPI: | 1932783123 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELANEY | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5628 HICKORY RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | SPOTSYLVANIA | ||||||||
| State: | VA | ||||||||
| PostalCode: | 225512450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408452318 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7969 ASHTON AVE | ||||||||
| Address2: | |||||||||
| City: | MANASSAS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201092885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037927800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2021 | ||||||||
| LastUpdateDate: | 08/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 0701010413 | VA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.