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General NPI Number Information
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NPI Number | 1518094150
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Entity Type | Individual
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Provider Name | CHERYL L THOMAS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 140 WADSWORTH RD
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City | WADSWORTH
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State | OH
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Zip | 44281-9503
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Country | US
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Telephone | 330-510-0222
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Fax | 330-334-2235
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Provider Business Mailing Address
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Address Line | 201 BURKDALE CT
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City | WADSWORTH
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State | OH
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Zip | 44281-8372
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Country | US
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Telephone | 330-351-0862
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Fax | 330-334-2235
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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 | ICDC. 131253-CS
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | F. 1300010
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.0602091
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License Number State | OH
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