Provider Demographics
NPI:1407088412
Name:POOL, TOMMY LEWIS II (LPC, LCDC)
Entity Type:Individual
Prefix:MR
First Name:TOMMY
Middle Name:LEWIS
Last Name:POOL
Suffix:II
Gender:M
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2516 59TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-5638
Mailing Address - Country:US
Mailing Address - Phone:432-653-4981
Mailing Address - Fax:
Practice Address - Street 1:2516 59TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-5638
Practice Address - Country:US
Practice Address - Phone:324-653-4981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10857101YA0400X
TX65821101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX12285614OtherCAQH
TX10857OtherLCDC
TX65821OtherSTATE OF TEXAS
TX2813990Medicaid