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General NPI Number Information
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NPI Number | 1871309724
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Entity Type | Individual
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Provider Name | MICHELLE ANTOINETTE THOMAS LMHC-T
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Gender | Female
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 82 HOLLAND ST
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City | ROCHESTER
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State | NY
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Zip | 14605-2199
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Country | US
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Telephone | 585-402-1906
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Fax |
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Provider Business Mailing Address
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Address Line | 82 HOLLAND ST
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City | ROCHESTER
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State | NY
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Zip | 14605-2131
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Country | US
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Telephone | 585-622-5786
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P132719
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License Number State | NY
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