Provider Demographics
NPI:1457373912
Name:THOMAS, JON V (PHD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:V
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13383 THEELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-9393
Mailing Address - Country:US
Mailing Address - Phone:330-375-3761
Mailing Address - Fax:330-375-4291
Practice Address - Street 1:55 ARCH ST.
Practice Address - Street 2:SUITE 3A
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1447
Practice Address - Country:US
Practice Address - Phone:330-375-3761
Practice Address - Fax:330-375-4291
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3095103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling