Individual provider Active NPI

Daniel Stephen Thoma, M.A.

  • Mental Health Counselor
  • Portland, OR
National Provider Identifier
1043549207
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C1140 Issued in OR
Practice address
601 SW 2ND Ave
Portland, OR 97204-3229
Phone
(503) 382-5386
Fax
(503) 670-8349
NPI assigned
Dec 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C1140 OR Primary

Addresses

Primary practice location

601 SW 2ND Ave
Portland, OR 97204-3229

Mailing address

601 SW 2ND Ave
Portland, OR 97204-3229
Phone (503) 382-5386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
C1140ORMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1043549207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SW 2ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972043229",
            "telephone_number": "503-382-5386",
            "fax_number": "503-670-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SW 2ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972043229",
            "telephone_number": "503-382-5386",
            "fax_number": "503-670-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMA",
        "first_name": "DANIEL",
        "middle_name": "STEPHEN",
        "name_prefix": "Mr.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-17",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C1140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.