Provider Demographics
NPI:1790497246
Name:THOMAS, REECE (LPC-MHSP (TEMP))
Entity Type:Individual
Prefix:
First Name:REECE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:X
Credentials:LPC-MHSP (TEMP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 21ST AVE S STE 201
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4927
Mailing Address - Country:US
Mailing Address - Phone:615-200-7761
Mailing Address - Fax:
Practice Address - Street 1:2300 21ST AVE S STE 201
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4927
Practice Address - Country:US
Practice Address - Phone:615-200-7761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-15
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6213101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health