Provider Demographics
NPI:1720625304
Name:THOMAS, JAMES B JR (LPC- TRAINEE/INTERN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:THOMAS
Suffix:JR
Gender:M
Credentials:LPC- TRAINEE/INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 GENEVA AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-2945
Mailing Address - Country:US
Mailing Address - Phone:202-904-0785
Mailing Address - Fax:
Practice Address - Street 1:4159 N HOLLAND SYLVANIA RD STE 205
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4801
Practice Address - Country:US
Practice Address - Phone:419-517-6564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator