Provider Demographics
NPI:1700107836
Name:THOMAS, EDWARD (LMHC)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
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 1:125 SOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-3036
Mailing Address - Country:US
Mailing Address - Phone:413-454-7428
Mailing Address - Fax:
Practice Address - Street 1:8803 VISTANA CENTRE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-6354
Practice Address - Country:US
Practice Address - Phone:413-454-7428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7027101YM0800X
FLMH19729101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health