Provider Demographics
NPI:1366017543
Name:THOMAS, KACIE (LCMHCA)
Entity Type:Individual
Prefix:
First Name:KACIE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 COX PL APT 2K
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-3442
Mailing Address - Country:US
Mailing Address - Phone:980-621-7247
Mailing Address - Fax:
Practice Address - Street 1:4101 COX PL
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-3441
Practice Address - Country:US
Practice Address - Phone:980-621-7247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health