Provider Demographics
NPI:1972852523
Name:THOMAS, ADAM WESLEY (LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:WESLEY
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2519 ROUTE 35 SOUTH
Mailing Address - Street 2:#M203
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736
Mailing Address - Country:US
Mailing Address - Phone:201-743-8052
Mailing Address - Fax:
Practice Address - Street 1:2519 ROUTE 35 SOUTH
Practice Address - Street 2:#M203
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736
Practice Address - Country:US
Practice Address - Phone:201-743-8052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional