MR. KENNETH HERBERT THOMAS JR. (NPI# 1023092335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023092335 |
| Entity Type | Individual |
| Full Name | MR. KENNETH HERBERT THOMAS JR. |
| Credential | CASAC, LPC |
| Practice Address |
Usa Meddac 11050 Mt Belvedere Blvd Fort Drum NY 13602-4025 |
| Mailing Address |
106 Rugby Rd Syracuse NY 13206-3225 |
| Practice Telephone | 3157728801 |
| Mailing Telephone | 3154636297 |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
8778 | NY | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1234436 | MI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316589534 | Kenneth Thomas | Counselor | 7 Rio San Jose, Laguna, NM 87026 | 2019-10-09 |
| 1205264140 | Kenneth Thomas | Counselor | 1010 E Southern Ave, 2, Phoenix, AZ 85040-3123 | 2013-10-30 |
| 1801153374 | Kenneth Lee Thomas | Radiologic Technologist | 166 Carolina Paradise Rd, Rutherfordton, NC 28139-8332 | 2012-04-20 |
| 1033495163 | Kenneth Fred Thomas Jr. | Physical Therapist | 1072 Market St Lowr Level, Sunbury, PA 17801-2458 | 2011-11-03 |
| 1124318811 | Kenneth N Thomas | Counselor | 3064 Penn Estates, East Stroudsburg, PA 18301-8696 | 2011-04-14 |
| 1083792071 | Kenneth C Thomas | Chiropractor | 2500 Walnut Hill Ln, Dallas, TX 75229-5609 | 2006-11-01 |
| 1124115506 | Kenneth L Thomas | Optometrist | 1372 W Robinhood Dr, Suite D, Stockton, CA 95207-5513 | 2006-10-06 |
| 1114020203 | Kenneth Darrell Thomas | Dentist | 250 East 300 South, Suite 320, Salt Lake City, UT 84111 | 2006-09-06 |
| 1033132568 | Kenneth C Thomas | Counselor | Smallwood Building, 2670 Crain Highway, Suite 525, Waldorf, MD 20601 | 2006-07-25 |
| 1689626566 | Kenneth Hunt Thomas | Anesthesiology | 7311 Van Nuys Blvd, Van Nuys, CA 91405-1999 | 2006-05-17 |
| Street Address |
USA MEDDAC 11050 MT BELVEDERE BLVD |
| City | FORT DRUM |
| State | NY |
| Zip Code | 13602-4025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538159512 | Jacqueline L Lucas | Social Worker | Usa Meddac, 11050 Mt Belvedere Blvd, Fort Drum, NY 13602-5004 | 2005-10-21 |
| 1497365563 | John Lewis Mcafee | Student in an Organized Health Care Education/Training Program | Usa Meddac, 11050 Mount Belvedere Blvd, Fort Drum, NY 13602 | 2020-08-04 |
| 1831746916 | Lindsay Caroline Wise | Physical Therapist | Usa Meddac, 11050 Mount Belvedere Blvd, Fort Drum, NY 13602-5438 | 2019-08-22 |
| 1215454855 | Emily Alexis Bartlett | Physical Therapist | Usa Meddac, 11050 Mount Belvedere Boulevard, Fort Drum, NY 13602-5004 | 2017-08-24 |
| 1841727534 | Faith Catherine Elise Moore | Internal Medicine | Usa Meddac, 11050 Mount Belvedere Blvd, Fort Drum, NY 13602 | 2017-05-12 |
| 1679932115 | Cornelia J Willis | Internal Medicine | Usa Meddac, 11050 Mount Belvedere Blvd, Fort Drum, NY 13602 | 2016-02-11 |
| 1982083812 | Griffin Matthew Biedron | Orthopaedic Surgery | Usa Meddac, 11050 Mt. Belvedere Blvd, Fort Drum, NY 13602 | 2015-05-26 |
| 1528453677 | Kelly Macdonald | Psychiatry & Neurology | Usa Meddac, 11050 Mount Belvedere Blvd, Fort Drum, NY 13602-5004 | 2015-04-04 |
| 1740680875 | Wesley Snow | Pharmacist | Usa Meddac, 11050 Mt. Belvedere Blvd, Fort Drum, NY 13602 | 2014-08-26 |
| 1689916439 | Stephen Keller | Psychologist | Usa Meddac, 11050 Mount Belvedere Blvd, Fort Drum, NY 13602 | 2013-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235697590 | Joshua Lee Hickman | Physician Assistant | Bldg P10506 Euphrates River Valley Rd, Fort Drum, NY 13602 | 2019-03-06 |
| 1447721345 | Lisa Marie Lewis | Social Worker | 11044 Mount Belvedere Blvd, Fort Drum, NY 13602 | 2018-12-17 |
| 1720555253 | Elizabeth M Hover | Social Worker | P11050 Mt Belvedere Blvd, Fort Drum, NY 13602 | 2018-11-02 |
| 1376037424 | Phillip Dakotah Mitchell | Physician Assistant | 10020 Euphrates River Valley Road, Fort Drum, NY 13602 | 2018-06-20 |
| 1063902666 | Guthrie Ahc | Clinic/Center | P19914 M3r Tampa, Fort Drum, NY 13602 | 2018-05-18 |
| 1255846879 | Morgan Elizabeth Callari | Dental Hygienist | 10205 S Riva Ridge Loop, Fort Drum, NY 13602 | 2017-12-05 |
| 1609389097 | John Charles Bockmann | Physician Assistant | Connor Troop Medical Clinic, 10506 Euphrates River Valley Rd, Fort Drum, NY 13602 | 2017-11-08 |
| 1902318207 | Nicholas Andrew Jones | Military Health Care Provider | 10506 S. Riva Ridge, Fort Drum, NY 13602 | 2017-10-26 |
| 1508389198 | Richard Scott Christiansen | Physical Therapist | 10330 S Riva Ridge Loop, Fort Drum, NY 13602 | 2017-07-25 |
| 1811418098 | Emer B Bajuelos | Dentist | Ft Drum W07uaa 10590, Ft Drum, Apo, AP 13602 | 2017-06-28 |
| Find all providers in zip 13602 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164759783 | Jeffrey Ogle Duprey | Counselor | 4th Armored Division Drive, Asap, Bldg# 10250, Fort Drum, NY 13602-7999 | 2009-11-04 |
| 1295882413 | Stephen Shatinsky | Counselor | 11050 Mount Belvedere Blvd, Usa Meddac Attn: Credentials, Fort Drum, NY 13602-5438 | 2007-01-03 |
| 1831176569 | Catherine L Harruff | Counselor | 11050 Mount Belvedere Blvd, Usa Meddac, Fort Drum, NY 13602-5438 | 2005-12-23 |
| 1326029489 | Don Bonham | Counselor | 11050 Mount Belvedere Blvd, Usa Meddac - Credentials, Fort Drum, NY 13602-5438 | 2005-11-07 |
| 1346230166 | Emma Elizabeth Miles | Counselor | 11050 Mount Belvedere Blvd, Attn: Mcid-bh-ccc, Fort Drum, NY 13602-5438 | 2005-10-24 |
| 1861482713 | Anne Ashley | Counselor | 11050 Mount Belvedere Blvd, Fort Drum, NY 13602-5438 | 2005-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578622 | Roberto Javier Torres | Counselor | 115 Angelacrest Ln, West Seneca, NY 14224-3819 | 2020-11-05 |
| 1386245595 | Liliana Maria Calle | Counselor | 1510 Waters Pl Fl 2, Bronx, NY 10461-2700 | 2020-11-04 |
| 1245831528 | Multi Assistance Resource Centers Inc. | Counselor | 509 Willis Ave Fl 4, Bronx, NY 10455-4001 | 2020-11-04 |
| 1952902371 | Brandon Chevere | Counselor | 175 Remsen St Fl 9, Brooklyn, NY 11201-4333 | 2020-11-03 |
| 1619577541 | Josselyn D Carias-rodriguez | Counselor | 90 Cherry Ln, Hicksville, NY 11801-6232 | 2020-10-29 |
| 1275133688 | Carol Hunt | Counselor | 76 Humboldt Pkwy, Buffalo, NY 14214-2605 | 2020-10-27 |
| 1598363806 | Anabel Lago-pedrick | Counselor | 539 County Road 40, Maplecrest, NY 12454-1245 | 2020-10-09 |
| 1386241511 | Kelly Jensen | Counselor | 255 Delaware Ave Ste 3000, Buffalo, NY 14202-2016 | 2020-10-01 |
| 1538776091 | James Mcrae | Counselor | 100 N Portland Ave Rm B228, Brooklyn, NY 11205-2005 | 2020-09-29 |
| 1215544036 | Jeanette Malpica-oskowitz | Counselor | 100 N Portland Ave # B217, Brooklyn, NY 11205-2005 | 2020-09-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.