Provider Demographics
NPI:1417679739
Name:THOMAS, KASYIDA (LPC)
Entity Type:Individual
Prefix:
First Name:KASYIDA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KASYIDA
Other - Middle Name:
Other - Last Name:BRIGGINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1016 GENEVA AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-4800
Mailing Address - Country:US
Mailing Address - Phone:516-850-6884
Mailing Address - Fax:
Practice Address - Street 1:500 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2205
Practice Address - Country:US
Practice Address - Phone:757-524-2458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011799101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty