Provider Demographics
NPI:1972237188
Name:THOMAS, EILEEN (CASAC ADVANCED)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CASAC ADVANCED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 FALLKILL PL
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1804
Mailing Address - Country:US
Mailing Address - Phone:845-483-7051
Mailing Address - Fax:
Practice Address - Street 1:7 FALLKILL PL
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1804
Practice Address - Country:US
Practice Address - Phone:845-483-7051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)