Individual provider Active NPI

Edward Thomas, LMHC

  • Mental Health Counselor
  • Orlando, FL
National Provider Identifier
1700107836
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH19729 Issued in FL
Practice address
8803 Vistana Centre Dr
Orlando, FL 32821-6354
Phone
(413) 454-7428
NPI assigned
Jun 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7027 MA
Mental Health Counselor 101YM0800X MH19729 FL Primary

Addresses

Primary practice location

8803 Vistana Centre Dr
Orlando, FL 32821-6354

Mailing address

125 South Ave
Longmeadow, MA 01106-3036
Phone (413) 454-7428

Other practice location 1

511 E Columbus Ave
Springfield, MA 01105-2506
Phone (413) 827-8959 ext. 1559

Other practice location 2

490 Page Blvd
Springfield, MA 01104-3026
Phone (413) 349-5033

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

State licenses

LicenseStateTypeSpecialty
MH19729FLMDMental Health Counselor
7027MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Physician Services LLC Mental Health CurrentSince Nov 1, 2023 Accepting new patients

Locations

512 W Cherry St
Ste C
Kissimmee, FL 34741
Phone (407) 460-0418

8803 Vistana Centre Dr
Orlando, FL 32821
Phone (413) 301-6019

490 Page Blvd
Springfield, MA 01104
Phone (413) 349-5033

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1700107836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 SOUTH AVE",
            "city": "LONGMEADOW",
            "state": "MA",
            "postal_code": "011063036",
            "telephone_number": "413-454-7428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8803 VISTANA CENTRE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216354",
            "telephone_number": "413-454-7428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "511 E Columbus Ave",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011052506",
            "country_code": "US",
            "telephone_number": "413-827-8959 x1559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "490 Page Blvd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011043026",
            "country_code": "US",
            "telephone_number": "413-349-5033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "EDWARD",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "7027",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH19729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.