Provider Demographics
NPI:1417216383
Name:THOMAS, HEATHER RENEE (LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RENEE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:MELILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918
Mailing Address - Street 2:
Mailing Address - City:BENNETTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29512
Mailing Address - Country:US
Mailing Address - Phone:843-454-0841
Mailing Address - Fax:843-454-0635
Practice Address - Street 1:1035 CHERAW STREET
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512
Practice Address - Country:US
Practice Address - Phone:843-454-0841
Practice Address - Fax:843-454-0635
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist