Provider Demographics
NPI:1689089849
Name:THOMAS, DONNA (LICDC-CS)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:878 COITSVILLE HUBBARD RD
Mailing Address - Street 2:RECOVERY SERVICES DEPT.
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-4635
Mailing Address - Country:US
Mailing Address - Phone:330-743-0700
Mailing Address - Fax:
Practice Address - Street 1:878 COITSVILLE HUBBARD RD
Practice Address - Street 2:RECOVERY SERVICES DEPT.
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-4635
Practice Address - Country:US
Practice Address - Phone:330-743-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC-CS101YA0400X
OHC.0006849101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional