Provider Demographics
NPI:1518705482
Name:THOMAS, ADALYN RAE (RHMCI)
Entity type:Individual
Prefix:
First Name:ADALYN
Middle Name:RAE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RHMCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2762 PEACHTREE CIR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-3838
Mailing Address - Country:US
Mailing Address - Phone:727-637-8812
Mailing Address - Fax:
Practice Address - Street 1:2759 STATE ROAD 580 STE 210
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3352
Practice Address - Country:US
Practice Address - Phone:727-804-8623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH26144101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health