Provider Demographics
NPI:1689229361
Name:THOMAS, SARA SIMPSON (LGPC)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:SIMPSON
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 E LORRAINE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-4712
Mailing Address - Country:US
Mailing Address - Phone:803-556-1228
Mailing Address - Fax:
Practice Address - Street 1:11 E LEXINGTON ST STE 400
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-1723
Practice Address - Country:US
Practice Address - Phone:443-708-5699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2023-05-25
Deactivation Date:2023-04-27
Deactivation Code:
Reactivation Date:2023-05-25
Provider Licenses
StateLicense IDTaxonomies
MD101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional