Provider Demographics
NPI:1437441573
Name:THOMAS, COURTNEY J'VON (LCPC)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:J'VON
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8940 OLD ANNAPOLIS RD
Mailing Address - Street 2:E
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2129
Mailing Address - Country:US
Mailing Address - Phone:443-602-6515
Mailing Address - Fax:
Practice Address - Street 1:8940 OLD ANNAPOLIS RD
Practice Address - Street 2:E
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2129
Practice Address - Country:US
Practice Address - Phone:443-602-6515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3911101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional