Mary Michele Thomas, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSYCHOLOGIST 1311 Issued in KY

Practice address

1011 Lehman Ave
Suite 104
Bowling Green, KY 42103-6515

Phone

(270) 843-8233

Fax

(270) 393-9835

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michele Burhard Thomas Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Anam Cara, LLC

  • Clinical Psychologist
  • Bowling Green, KY
  • NPI 1548394943
  NPD (past) Authorized official

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326172727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 LEHMAN AVE",
            "address_2": "SUITE 104",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421036515",
            "telephone_number": "270-843-8233",
            "fax_number": "270-393-9835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 LEHMAN AVE",
            "address_2": "SUITE 104",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421036515",
            "telephone_number": "270-843-8233",
            "fax_number": "270-393-9835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MARY",
        "middle_name": "MICHELE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "PSYCHOLOGIST 1311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BLUE SHIELD",
            "identifier": "000000358793",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "THOMAS",
            "middle_name": "BURHARD",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• George Wesley Thomas, MD
• Holly Ann Thomas, DO
• Jacob Clayton Thomas, PT, DPT
• Janice Thomas
• Jodi Thomas
• Anna Thomerson
• Holly R Thomerson, FNP
• Darian Thompson
• Kelly Lynn Thompson
• Kimberly Thompson, OTR

• Clinical Psychologist in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Clinical Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.