Provider Demographics
NPI:1861562092
Name:THOMAS, MITCHELL CRAIG (MFT)
Entity type:Individual
Prefix:MR
First Name:MITCHELL
Middle Name:CRAIG
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 QUINCY ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-3527
Mailing Address - Country:US
Mailing Address - Phone:775-313-3377
Mailing Address - Fax:775-825-4025
Practice Address - Street 1:605 QUINCY ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-3527
Practice Address - Country:US
Practice Address - Phone:775-313-3377
Practice Address - Fax:775-825-4025
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV485106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV485OtherMFT.