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NPI Code Detail

MEDICARE: EBONY THOMAS

MEDICARE: EBONY THOMAS
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1659177863
Entity Type Code : Individual
Provider Name (Legal Business Name) : EBONY THOMAS
Provider Business Mailing Address
First Line : 223 GIBBSBORO RD
Second Line :
City : CLEMENTON
State : NJ
Zip : 08021-4135
Country : US
Telephone Number : 609-889-8100
Fax Number :
Provider Business Practice Location Address
First Line : 223 GIBBSBORO RD
Second Line :
City : CLEMENTON
State : NJ
Zip : 08021-4135
Country : US
Telephone Number : 609-889-8100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2025
Last Update Date : 02/20/2025

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Directions to “ EBONY THOMAS ” Practice Location

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