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General NPI Number Information
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NPI Number | 1720625304
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Entity Type | Individual
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Provider Name | JAMES B THOMAS JR. LPC- TRAINEE/INTERN
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Gender | Male
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Dates
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Enumeration Date | 12/03/2019
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 4159 N HOLLAND SYLVANIA RD STE 205
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City | TOLEDO
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State | OH
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Zip | 43623-4801
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Country | US
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Telephone | 419-517-6564
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Fax |
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Provider Business Mailing Address
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Address Line | 521 GENEVA AVE
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City | TOLEDO
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State | OH
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Zip | 43609-2945
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Country | US
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Telephone | 202-904-0785
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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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 |
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License Number State |
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