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Provider Information for 1790271583


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DAVID TODD THOMAS MA, LLPC, NCC


Sex: Male

NPI: 1790271583
Last Updated: 2018-07-05
Certification Date:

Details

NameValue
NPI1790271583
Enumeration Date2018-07-05
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 2985 TAHOE AVE
KALAMAZOO, MI 49004-2144
United States

Phone: 269-806-2862 | Fax:
 
Primary Practice Address 1000 W PATERSON ST
KALAMAZOO, MI 49007-1710
United States

Phone: 269-389-9951 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YP2500X - Counselor - ProfessionalMI6401016099