Provider Demographics
NPI:1972475952
Name:THOMAS, LAYNE AARON
Entity type:Individual
Prefix:
First Name:LAYNE
Middle Name:AARON
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 SNAKE CLAN RD
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34974-6963
Mailing Address - Country:US
Mailing Address - Phone:863-763-7700
Mailing Address - Fax:
Practice Address - Street 1:500 E HARNEY POND RD NE
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34974-2766
Practice Address - Country:US
Practice Address - Phone:863-763-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL28219101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health