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General NPI Number Information
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NPI Number | 1235322272
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Entity Type | Individual
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Provider Name | JOHN C THOMAS PH.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 08/23/2007
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Provider Practice Location Address
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Address Line | 1971 UNIVERSITY BLVD CENTER FOR COUNSELING AND FAMILY STUDIES, SUITE 2400 CN
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City | LYNCHBURG
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State | VA
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Zip | 24502-2269
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Country | US
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Telephone | 434-592-4047
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Fax |
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Provider Business Mailing Address
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Address Line | 201 MULLBURY PL
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City | LYNCHBURG
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State | VA
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Zip | 24502-5822
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Country | US
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Telephone | 434-592-4047
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0776
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2022
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License Number State | VA
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