Provider Demographics
NPI:1427488600
Name:SUMMERS, THOMAS (EDD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:SUMMERS
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:DR
Other - First Name:THOMAS
Other - Middle Name:MORGAN
Other - Last Name:SUMMERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:EDD
Mailing Address - Street 1:5808 SW 95TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-5551
Mailing Address - Country:US
Mailing Address - Phone:352-870-0643
Mailing Address - Fax:
Practice Address - Street 1:5808 SW 95TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-5551
Practice Address - Country:US
Practice Address - Phone:352-870-0643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4506101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health