| Dr. Tre Thomas, Psychologist, Pllc | |
|
616 Camellia Ave Ellenton FL 34222-2438 | |
| (813) 498-9349 | |
| (941) 894-1312 |
| Full Name | Dr. Tre Thomas, Psychologist, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 616 Camellia Ave, Ellenton, Florida |
| Authorized Official Name and Position | Trajana Noel Thomas (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8134989349 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Tre Thomas, Psychologist, Pllc 616 Camellia Ave Ellenton FL 34222-2438 Ph: (813) 498-9349 | Dr. Tre Thomas, Psychologist, Pllc 616 Camellia Ave Ellenton FL 34222-2438 Ph: (813) 498-9349 |
| NPI Number | 1710582010 |
|---|---|
| Provider Enumeration Date | 12/03/2020 |
| Last Update Date | 12/03/2020 |
| Certification Date | 12/01/2020 |
| Medicare PECOS PAC ID | 5496160707 |
|---|---|
| Medicare Enrollment ID | O20210219000030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710582010 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Trajana Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154578201 PECOS PAC ID: 6305251612 Enrollment ID: I20210219000166 |
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