Provider Demographics
NPI:1639644883
Name:THOMAS, LATOYA SHAMORA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:LATOYA
Middle Name:SHAMORA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 CLARK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:RANDOLOH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-3613
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13 CLARK CIRCLE
Practice Address - Street 2:
Practice Address - City:RANDOLOH
Practice Address - State:MA
Practice Address - Zip Code:02368-3613
Practice Address - Country:US
Practice Address - Phone:857-576-2081
Practice Address - Fax:857-267-5649
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA8725OtherMA LMHC