Healthcare Provider Details

I. General information

NPI: 1417732629
Provider Name (Legal Business Name): CHRISTOPHER JOSEPH THOMAS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S HILL DR
BLACKSBURG VA
24060-5709
US

IV. Provider business mailing address

5277 GRANDVIEW DR
DUBLIN VA
24084-5806
US

V. Phone/Fax

Practice location:
  • Phone: 540-516-3043
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701016623
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: