Provider Demographics
NPI:1689396020
Name:THOMAS, SARANYA
Entity Type:Individual
Prefix:
First Name:SARANYA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARANYA
Other - Middle Name:
Other - Last Name:PHURIVETH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SARANYA PHURIVETH
Mailing Address - Street 1:55 ELLIOTT RD
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02632-3642
Mailing Address - Country:US
Mailing Address - Phone:518-229-2555
Mailing Address - Fax:
Practice Address - Street 1:100 INDEPENDENCE DR # 8
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1898
Practice Address - Country:US
Practice Address - Phone:508-778-1839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health