Provider Demographics
NPI:1093067985
Name:THOMAS, PIPPA S (CMHC)
Entity Type:Individual
Prefix:
First Name:PIPPA
Middle Name:S
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:977 ROWENA CT
Mailing Address - Street 2:
Mailing Address - City:MOAB
Mailing Address - State:UT
Mailing Address - Zip Code:84532-2855
Mailing Address - Country:US
Mailing Address - Phone:435-220-1012
Mailing Address - Fax:
Practice Address - Street 1:50 E CENTER ST STE 8
Practice Address - Street 2:
Practice Address - City:MOAB
Practice Address - State:UT
Practice Address - Zip Code:84532-2473
Practice Address - Country:US
Practice Address - Phone:435-220-1012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-03
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT56667676004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health