Healthcare Provider Details

I. General information

NPI: 1790497246
Provider Name (Legal Business Name): REECE THOMAS LC, LMHC, CMHC
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2022
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 5637
BALTIMORE MD
21210-0637
US

IV. Provider business mailing address

2221 WINDSOR AVE
BALTIMORE MD
21216-3226
US

V. Phone/Fax

Practice location:
  • Phone: 615-905-9103
  • Fax:
Mailing address:
  • Phone: 615-905-6103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17144
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: