Provider Demographics
NPI:1275674046
Name:THOMAS, CHRISTINA JOAN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:JOAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 E 64TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1671
Mailing Address - Country:US
Mailing Address - Phone:317-459-7321
Mailing Address - Fax:
Practice Address - Street 1:819 E 64TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-1671
Practice Address - Country:US
Practice Address - Phone:317-459-7321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001487A101YP1600X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN268352Medicare UPIN
INTHOMCHRIMedicare UPIN
INTHOMA-0029Medicare UPIN