Provider Demographics
NPI:1437265451
Name:THOMAS, MICHAEL W (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307B W ABRAM ST
Mailing Address - Street 2:#212
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-1700
Mailing Address - Country:US
Mailing Address - Phone:817-275-0173
Mailing Address - Fax:817-275-0317
Practice Address - Street 1:1307B W ABRAM ST
Practice Address - Street 2:#212
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-1700
Practice Address - Country:US
Practice Address - Phone:817-275-0173
Practice Address - Fax:817-275-0317
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6137101YP2500X
TX2716106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist