Provider Demographics
NPI:1245794767
Name:THOMAS, KIMBERLY DENISE (LPC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:DENISE
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 1:15941 DONALD CURTIS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-4257
Mailing Address - Country:US
Mailing Address - Phone:703-792-4900
Mailing Address - Fax:703-792-5699
Practice Address - Street 1:15941 DONALD CURTIS DR STE 200
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-4257
Practice Address - Country:US
Practice Address - Phone:703-792-4900
Practice Address - Fax:703-792-5699
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008106101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional