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Individual
THOMAS J. SUPAN
Active
Individual
THOMAS J. SUPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
E-988
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000216098
ANTHEM BLUE CROSS PIN
OH
01
—
353306
WELLCARE HEALTH PLAN
OH
01
—
741000
BUCKEYE HEALTH PLAN
OH
01
—
7745428
AETNA
OH
01
—
T00988
SUMMACARE HEALTH PLAN
OH
Enumeration date
07/19/2006
Last updated
05/14/2008
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