Provider Demographics
NPI:1073207593
Name:THOMAS, ADAM GLENN (PSYD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:GLENN
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 FORT MYER DR STE 745
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22209-3113
Mailing Address - Country:US
Mailing Address - Phone:703-596-3975
Mailing Address - Fax:
Practice Address - Street 1:1655 FORT MYER DR STE 745
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22209-3113
Practice Address - Country:US
Practice Address - Phone:703-596-3975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist