Healthcare Provider Details

I. General information

NPI: 1447043583
Provider Name (Legal Business Name): KAREEM THOMAS QMHP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N MAIN ST STE 200
FRANKLIN VA
23851-1700
US

IV. Provider business mailing address

3523 FRANCIS ST
PETERSBURG VA
23805-9350
US

V. Phone/Fax

Practice location:
  • Phone: 804-926-6392
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0732009974
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: