Healthcare Provider Details

I. General information

NPI: 1386161891
Provider Name (Legal Business Name): ERIC C THOMAS LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 FAIRGROVE AVE
HAMILTON OH
45011-1966
US

IV. Provider business mailing address

7841 RED MILL DR
WEST CHESTER OH
45069-1730
US

V. Phone/Fax

Practice location:
  • Phone: 513-889-5880
  • Fax:
Mailing address:
  • Phone: 513-846-5144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.1500091
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE1901429
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: