Provider Demographics
NPI:1124275359
Name:THOMAS, ANTHONY ADRIAN (MA, LMHC)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:ADRIAN
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 HIGH AVE
Mailing Address - Street 2:UNIT 307
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-2500
Mailing Address - Country:US
Mailing Address - Phone:845-675-7616
Mailing Address - Fax:
Practice Address - Street 1:107 HIGH AVE
Practice Address - Street 2:UNIT 307
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-2500
Practice Address - Country:US
Practice Address - Phone:845-675-7616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001178101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health