MEDICARE: DR. SHAMARAH J THOMAS-HUTCHINS PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDCA.121505	OH
2	171M00000X	Case Manager/Care Coordinator
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	LICDC.161704	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316456882
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAMARAH J THOMAS-HUTCHINS PH.D.

Provider Business Mailing Address
First Line	:	33140 AURORA RD STE 3
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-3650
Country	:	US
Telephone Number	:	440-290-1083
Fax Number	:

Provider Business Practice Location Address
First Line	:	33140 AURORA RD STE 3
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-3650
Country	:	US
Telephone Number	:	440-290-1083
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2017
Last Update Date	:	01/08/2025

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