Provider Demographics
NPI:1487697611
Name:PELTZ, THOMAS ADAMS (LMHC, LADAC1, CAS)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ADAMS
Last Name:PELTZ
Suffix:
Gender:M
Credentials:LMHC, LADAC1, CAS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 5554
Mailing Address - Street 2:
Mailing Address - City:BEVERLY FARMS
Mailing Address - State:MA
Mailing Address - Zip Code:01915-0520
Mailing Address - Country:US
Mailing Address - Phone:978-927-6763
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL PSYCHOLOGY CENTER
Practice Address - Street 2:100 CUMMINGS CENTER, SUITE 456J
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-6106
Practice Address - Country:US
Practice Address - Phone:978-921-4000
Practice Address - Fax:978-921-7530
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALADAC1 # 75101YA0400X
MALMHC # 321101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health