Provider Demographics
NPI:1275396756
Name:TALAIA THOMAS, LCMHC, LLC
Entity Type:Organization
Organization Name:TALAIA THOMAS, LCMHC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TALAIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:802-279-8575
Mailing Address - Street 1:PO BOX 315
Mailing Address - Street 2:
Mailing Address - City:HARDWICK
Mailing Address - State:VT
Mailing Address - Zip Code:05843-0315
Mailing Address - Country:US
Mailing Address - Phone:802-279-8575
Mailing Address - Fax:
Practice Address - Street 1:4 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HARDWICK
Practice Address - State:VT
Practice Address - Zip Code:05843-7070
Practice Address - Country:US
Practice Address - Phone:802-279-8575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty