Provider Demographics
NPI:1245394998
Name:THOMAS, AIMEE (PHD, JD LPCC)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHD, JD LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 9TH ST SW STE 1610
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44707-4714
Mailing Address - Country:US
Mailing Address - Phone:330-305-2753
Mailing Address - Fax:330-639-1712
Practice Address - Street 1:408 9TH ST SW STE 1610
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44707-4714
Practice Address - Country:US
Practice Address - Phone:330-305-2753
Practice Address - Fax:330-639-2753
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE3352101Y00000X, 101YM0800X, 101YP2500X, 106H00000X
OH6989103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH10034Medicaid
OH10024Medicaid