Thom Daniel Balmer, PH.D.
Individual provider Active NPI Marriage & Family Therapist · Ada, OK
NPI 1609933126 · NPPES record last updated Jul 13, 2011
Key facts
- NPI
- 1609933126
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 699 (OK)
- Practice address
- 901 East 16TH Street
Arbuckle Life Solutions
Ada, OK 74820 - Phone
- (580) 226-1656
- NPI assigned
- Jan 3, 2007
- 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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1028 | OK | MD | Psychologist |
| 699 | OK | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1028 | OK | |
| Marriage & Family Therapist | 106H00000X | 699 | OK | Yes |
| Mental Health Counselor | 101YM0800X | 1028 | OK |
Addresses
Primary practice location
901 East 16TH Street
Arbuckle Life Solutions
Ada, OK 74820
Mailing address
901 East 16TH Street
Arbuckle Life Solutions
Ada, OK 74820
Phone (580) 559-5839
Other providers in Ada, OK
- Aerial A Avery
- Tara Lynn Bailey
- Alicia Dawn Baker
- Ramona Juanita Baker
- William J Baker
- Ashtami Vishwanath Banavali
- Hadley Banks
- Adam Barker
- Jennifer Michelle Barker
- Kendra Barker
All providers in Ada, OK · Marriage & Family Therapist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2011. 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.