Provider Demographics
NPI:1568520005
Name:THOMAS, SANDRA E (LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:E
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 UPLAND DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-4710
Mailing Address - Country:US
Mailing Address - Phone:713-697-0776
Mailing Address - Fax:713-697-2309
Practice Address - Street 1:4625 NORTH FWY
Practice Address - Street 2:SUITE 127
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-2914
Practice Address - Country:US
Practice Address - Phone:713-697-0776
Practice Address - Fax:713-697-2309
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13205101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171369501Medicaid