Provider Demographics
NPI:1790882363
Name:THOMAS, CAROL A (LPC)
Entity Type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
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 1:437 E FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-1514
Mailing Address - Country:US
Mailing Address - Phone:412-445-7480
Mailing Address - Fax:
Practice Address - Street 1:101 S MAIN ST
Practice Address - Street 2:
Practice Address - City:COOPERSBURG
Practice Address - State:PA
Practice Address - Zip Code:18036-1912
Practice Address - Country:US
Practice Address - Phone:484-963-1010
Practice Address - Fax:484-863-1011
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004168101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional