MEDICARE: YOLANDA MARIE THOMAS

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	101YM0800X	Mental Health Counselor	7262-125	WI
2	101YP2500X	Professional Counselor	7264-125	WI
3	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1407382534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA MARIE THOMAS

Provider Business Mailing Address
First Line	:	9205 W CENTER ST STE 200
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-4548
Country	:	US
Telephone Number	:	262-229-9018
Fax Number	:

Provider Business Practice Location Address
First Line	:	9205 W CENTER ST STE 200
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53222-4548
Country	:	US
Telephone Number	:	262-229-9018
Fax Number	:

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

Provider Enumeration Date	:	05/10/2017
Last Update Date	:	01/13/2025

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Directions to “ YOLANDA MARIE THOMAS ” Practice Location

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