Thomas, Michael Anthony

Thomas, Michael Anthony is an sole proprietor health care provider with primary practice located at 212 N Sycamore St , Petersburg VA 23803-3248. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Thomas, Michael Anthony can be contacted via phone (804) 919-1199.

Contact Information

Primary practice address
212 N Sycamore St Petersburg VA 23803-3248
Phone: (804) 919-1199
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701003107 Virginia

Profile Details

NPI number 1144232919
LBN Legal business name Thomas, Michael Anthony
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144232919 NPPES
Virginia MEDICAID 0101111692

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