Provider Demographics
NPI:1588016711
Name:THOMAS, SANTORA (LPC)
Entity Type:Individual
Prefix:
First Name:SANTORA
Middle Name:
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 1:710 W PRIEN LAKE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-8349
Mailing Address - Country:US
Mailing Address - Phone:337-310-2822
Mailing Address - Fax:
Practice Address - Street 1:710 W PRIEN LAKE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-8349
Practice Address - Country:US
Practice Address - Phone:337-310-2822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor