What is Cleveland Thibodeaux's NPI number?

The NPI number assigned to this healthcare provider is 1740800531, enumerated as a individual on April 21, 2020.

Where is the provider located?

The provider is located at 2101 COURAGE DR FAIRFIELD, CA 94533 and the phone number is (707) 428-1131.

What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101Y00000X.

CLEVELAND ANTHONY THIBODEAUX III - NPI 1740800531

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About Cleveland Anthony Thibodeaux Iii NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLEVELAND ANTHONY THIBODEAUX III (NPI 1740800531) is an individual counselor in Fairfield, California and active in the NPI registry since April 2020.

NPPES Registry Identity

NPI1740800531

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameCLEVELAND ANTHONY THIBODEAUX III

Location Address2101 COURAGE DRFairfield, CA 94533-6717

Mailing Address1966 Finch WayFairfield, CA 94533-2312 · (707) 389-1563

Phone(707) 428-1131

Sole ProprietorNo

Enumeration DateApril 21, 2020

NPPES CertifiedApril 21, 2020

✔ NPI 1740800531 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

2101 COURAGE DR, Fairfield, CA 94533

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