Individual
MICHAEL ANTHONY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
212 N SYCAMORE ST, PETERSBURG, VA 23803-3248
(804) 919-1199
Mailing address
15818 SANDWAVE RD, CHESTER, VA 23831-7310
(804) 504-0016
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701003107
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101111692
—
VA
Enumeration date
08/12/2006
Last updated
07/08/2007
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