Provider Demographics
NPI:1013523117
Name:THOMAS, WADE P (LMHC)
Entity Type:Individual
Prefix:
First Name:WADE
Middle Name:P
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 N MERIDIAN ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-1108
Mailing Address - Country:US
Mailing Address - Phone:317-287-3727
Mailing Address - Fax:317-287-3739
Practice Address - Street 1:832 N MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-1108
Practice Address - Country:US
Practice Address - Phone:317-287-3727
Practice Address - Fax:317-287-3739
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39003804A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health