| Doctor Name: | KENNETH C THOMAS |
| NPI Number: | 1033132568 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC |
| License Number: | LC2153 |
| Business Practice Address: | Smallwood Building 2670 Crain Highway, Suite 525 Waldorf, MD - 20601 |
| Business Phone Number: | 3016322100 |
| Business Fax Number: | 3016322150 |
| Mailing Address: | Trico Corporation, P.o. Box 826 LEXINGTON PARK |
| State: | MD |
| Postal Code: | 20653 |
| Phone Number: | 3018624966 |
| Fax Number: | 3018625554 |
| NPI Enumeration Date: | 07/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LC2153 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |