Provider Demographics
NPI:1053989095
Name:REGISTER, JAMES THOMAS
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:THOMAS
Last Name:REGISTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35052 WHISPERING OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33523-9415
Mailing Address - Country:US
Mailing Address - Phone:352-457-8003
Mailing Address - Fax:
Practice Address - Street 1:5331 COMMERCIAL WAY STE 203
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1426
Practice Address - Country:US
Practice Address - Phone:352-204-1169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health