Provider Demographics
NPI:1003887605
Name:THOMAS, PATRICIA PRINCE (LPC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:PRINCE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 N ACADEMY ST APT A319
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-3878
Mailing Address - Country:US
Mailing Address - Phone:615-631-0134
Mailing Address - Fax:
Practice Address - Street 1:319 N ACADEMY ST APT A319
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3878
Practice Address - Country:US
Practice Address - Phone:615-631-0134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-31
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003423101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor