Malcolm L Thomas Jr.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH16592 Issued in FL

Practice address

8400 N University Dr Ste 114
Tamarac, FL 33321-1700

Phone

(954) 562-1955

Fax

(954) 510-6935

NPI assigned

Oct 30, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Trinity Therapeutic Wellness Center LLC

  • Mental Health Counselor
  • Tamarac, FL
  • NPI 1497355044
  NPD Authorized official

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1477153187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4960 NW 16TH ST",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333135526",
            "telephone_number": "954-562-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 N UNIVERSITY DR STE 114",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333211700",
            "telephone_number": "954-562-1955",
            "fax_number": "954-510-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MALCOLM",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-30",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT1965",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "infor@ttwellnesscenter.com",
            "affiliation": "N",
            "endpointDescription": "365 encryption",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8400 N University Dr Ste 114",
            "city": "Tamarac",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333211700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Theracare Community Center, Inc.
• Therapeutically Beautiful, LLC
• Ananya Sri Thiriveedhi
• Thomas R O'Neil, DDS, PA
• Anthony Thomas
• Dominique Thompson
• Gawaine Thompson
• Kelia Thompson, FNP-BC
• Nicola Thompson
• Sydney Elaine Thompson

• Mental Health Counselor in Tamarac, FL
• Providers in Tamarac, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.