MEDICARE: DR. AIMEE THOMAS PH.D., JD LPCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	E3352	OH
2	103T00000X	Psychologist	6989	OH
3	101YM0800X	Mental Health Counselor	E3352	OH
4	101YP2500X	Professional Counselor	E3352	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245394998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AIMEE THOMAS PH.D., JD LPCC

Provider Business Mailing Address
First Line	:	408 9TH ST SW STE 1610
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44707-4714
Country	:	US
Telephone Number	:	330-305-2753
Fax Number	:	330-639-1712

Provider Business Practice Location Address
First Line	:	408 9TH ST SW STE 1610
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44707-4714
Country	:	US
Telephone Number	:	330-305-2753
Fax Number	:	330-639-2753

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	03/08/2019

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