Shelissa F Thomas, CDC1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

3185 Issued in AK

Practice address

542 4TH Ave Ste B101
Fairbanks, AK 99701

Phone

(907) 374-1097

Fax

(907) 457-2196

NPI assigned

Sep 15, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1952634420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 82321",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997082321",
            "telephone_number": "907-457-2176",
            "fax_number": "907-457-2196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 4TH AVE STE B101",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "99701",
            "telephone_number": "907-374-1097",
            "fax_number": "907-457-2196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SHELISSA",
        "middle_name": "F",
        "credential": "CDC1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AK",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AK",
            "license": "3185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251C00000X",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE COORDINATOR ADMINISTRATOR",
            "identifier": "251C00000X",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADDICTION  COUNSELOR",
            "identifier": "3185",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Thomas, BHC
• Eva Thomas
• Loren S Thomas
• Olivia Andrea Thomas, APRN
• Ruby Thomas
• Timothy Thomas
• June M Thomasson, PA
• Diane R Thompson
• Kelsey Rae Thompson, PA-C
• Leif Thompson, MD

• Addiction (Substance Use Disorder) Counselor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Addiction (Substance Use Disorder) Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; 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.