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Individual
THOMAS JOHN AMAYA SR.
Active
Individual
THOMAS JOHN AMAYA SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC, LAC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
778
MT
101YA0400X
Addiction (Substance Use Disorder) Counselor
1101
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0256989
—
MT
01
—
1101
LICENSE FOR LAC
MT
01
—
778
LICENSE FOR LCPC
MT
Enumeration date
12/07/2006
Last updated
02/11/2008
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