Provider Demographics
NPI:1316423494
Name:PIKE, THOMAS CHARLES (LPC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:CHARLES
Last Name:PIKE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1124
Mailing Address - Country:US
Mailing Address - Phone:541-227-3124
Mailing Address - Fax:
Practice Address - Street 1:248 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1124
Practice Address - Country:US
Practice Address - Phone:541-227-3124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-12
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC3925101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor