Healthcare Provider Details

I. General information

NPI: 1285576819
Provider Name (Legal Business Name): ANTONIO CHRISTOPHER THOMAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PENNSYLVANIA AVE SE STE 201
WASHINGTON DC
20003-2152
US

IV. Provider business mailing address

2611 DOUGLASS RD SE
WASHINGTON DC
20020-6582
US

V. Phone/Fax

Practice location:
  • Phone: 202-821-9456
  • Fax:
Mailing address:
  • Phone: 202-821-9456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: