Kenneth Herbert Thomas Jr., CASAC, LPC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

8778 Issued in NY

Practice address

USA Meddac
11050 Mt Belvedere Blvd
Fort Drum, NY 13602-4025

Phone

(315) 772-8801

NPI assigned

Nov 30, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1023092335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 RUGBY RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132063225",
            "telephone_number": "315-463-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA MEDDAC",
            "address_2": "11050 MT BELVEDERE BLVD",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136024025",
            "telephone_number": "315-772-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "KENNETH",
        "middle_name": "HERBERT",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CASAC,   LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "1234436",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "8778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Takayesu, PT, DPT
• Bryan Tappen, DMD
• Whitney Tarkington, RDH
• Katlyn Tavarres
• Danielle Terrill, MD, MPH
• Phillip J Todd, D.O
• Cleann Toner, PHARMD
• Michele Lynn Tornabene, LCSW-C,
• Dwayne Trinidad, DENTAL ASSISTANT X2
• Jean Reynolds Truitt

• Addiction (Substance Use Disorder) Counselor in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Addiction (Substance Use Disorder) Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.