Provider Demographics
NPI:1083928113
Name:THOMAS, CARRIE (LPC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
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 1:1325 PATTON ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4231
Mailing Address - Country:US
Mailing Address - Phone:970-646-6566
Mailing Address - Fax:
Practice Address - Street 1:151 S COLLEGE AVE
Practice Address - Street 2:SUITE A2
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-2864
Practice Address - Country:US
Practice Address - Phone:970-449-2087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-30
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0011375101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional