Provider Demographics
NPI:1689996191
Name:THOMAS, DAMIEN (NCC, LPC, LPC-S, DPC)
Entity Type:Individual
Prefix:DR
First Name:DAMIEN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:NCC, LPC, LPC-S, DPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 RIVERVIEW DR STE B
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-8924
Mailing Address - Country:US
Mailing Address - Phone:601-981-2707
Mailing Address - Fax:601-981-2701
Practice Address - Street 1:132 RIVERVIEW DR STE B
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8924
Practice Address - Country:US
Practice Address - Phone:601-981-2707
Practice Address - Fax:601-981-2701
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1425101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional