Healthcare Provider Details

I. General information

NPI: 1821901760
Provider Name (Legal Business Name): KOLEEN THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26250 EUCLID AVE STE 611
EUCLID OH
44132-3693
US

IV. Provider business mailing address

3441 WASHINGTON BLVD
CLEVELAND HTS OH
44118-2551
US

V. Phone/Fax

Practice location:
  • Phone: 216-337-1411
  • Fax: 216-223-8938
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: