Thomas Chapmond, LCDC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Edgewood, TX
NPI 1144670779 · NPPES record last updated Jun 14, 2016
Key facts
- NPI
- 1144670779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 11958 (TX)
- Practice address
- 343 VZ County Road 3122
Edgewood, TX 75117-5149 - Phone
- (903) 574-0599
- NPI assigned
- Jun 14, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11958 | TX | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 11958 | TX | Yes |
Addresses
Primary practice location
343 VZ County Road 3122
Edgewood, TX 75117-5149
Mailing address
PO Box 1114
Canton, TX 75103-7114
Phone (903) 574-0599
Other providers in Edgewood, TX
- Bulldog Pharmacy, LLC
- Yvonne Carol Dixon
- Tiffany Dunn
- East Texas Out-Patient PLLC
- East Texas Pediatric Therapy
- Edgewood Drug Inc
All providers in Edgewood, TX · Addiction (Substance Use Disorder) Counselor in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.