MEDICARE: MR. WILLIAM THOMAS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	101YP2500X	Professional Counselor
2	102X00000X	Poetry Therapist
3	103K00000X	Behavior Analyst	MI
4	1041C0700X	Clinical Social Worker	MI
5	1041S0200X	School Social Worker
6	1744R1102X	Research Study Specialist
7	1744R1103X	Research Study Abstracter/Coder
8	174H00000X	Health Educator
9	225800000X	Recreation Therapist
10	226300000X	Kinesiotherapist
11	171M00000X	Case Manager/Care Coordinator	MI

General Provider Information

NPI Number	:	1780157347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM THOMAS

Provider Business Mailing Address
First Line	:	30835 W 10 MILE RD # 1013
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2607
Country	:	US
Telephone Number	:	734-686-1730
Fax Number	:	800-519-5953

Provider Business Practice Location Address
First Line	:	30835 W 10 MILE RD # 1013
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-2607
Country	:	US
Telephone Number	:	734-686-1730
Fax Number	:	800-519-5953

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

Provider Enumeration Date	:	01/07/2019
Last Update Date	:	01/07/2019

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Directions to “ MR. WILLIAM THOMAS ” Practice Location

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