Individual
DEREK TIMOTHY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICDC-CS, LPCC
Contact information
Practice address
885 E BUCHTEL AVE, AKRON, OH 44305-2338
(330) 535-8116
Mailing address
885 E BUCHTEL AVE, AKRON, OH 44305-2338
(330) 535-8116
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.162017
OH
101YM0800X
Mental Health Counselor
Primary
E.2404724
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166425
—
OH
Enumeration date
05/04/2018
Last updated
09/30/2024
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