Provider Demographics
NPI:1407439151
Name:THOMAS THERAPEUTIC NETWORK, PLLC
Entity Type:Organization
Organization Name:THOMAS THERAPEUTIC NETWORK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAYNA
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:NCC, LCMHC, CRC
Authorized Official - Phone:646-591-9006
Mailing Address - Street 1:1208 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-3847
Mailing Address - Country:US
Mailing Address - Phone:646-591-9006
Mailing Address - Fax:
Practice Address - Street 1:2500 REGENCY PKWY
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8549
Practice Address - Country:US
Practice Address - Phone:646-591-9006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)