Provider Demographics
NPI:1881893105
Name:GREANEY, THOMAS M (LADC, LCDP)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:M
Last Name:GREANEY
Suffix:
Gender:M
Credentials:LADC, LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2504
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-0925
Mailing Address - Country:US
Mailing Address - Phone:860-912-2944
Mailing Address - Fax:
Practice Address - Street 1:260 S FRONTAGE RD STE 204
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-2637
Practice Address - Country:US
Practice Address - Phone:860-912-2944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI382101YA0400X
101YA0400X
CT629101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)