MEDICARE: RICHARD VERNON 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
2	101YM0800X	Mental Health Counselor	LPC-16808	AZ

General Provider Information

NPI Number	:	1598177073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD VERNON THOMAS

Provider Business Mailing Address
First Line	:	340 N EUCALYPTUS PL
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85225-8254
Country	:	US
Telephone Number	:	602-837-5500
Fax Number	:

Provider Business Practice Location Address
First Line	:	4140 E BASELINE RD STE 101
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4413
Country	:	US
Telephone Number	:	602-837-5500
Fax Number	:

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

Provider Enumeration Date	:	06/02/2014
Last Update Date	:	08/05/2021

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Directions to “ RICHARD VERNON THOMAS ” Practice Location

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