Provider Demographics
NPI:1801223532
Name:THOMAS, CAROLYN DENISE (THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:DENISE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 LOUISIANA ST
Mailing Address - Street 2:, SUITE 211
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-5712
Mailing Address - Country:US
Mailing Address - Phone:501-951-2629
Mailing Address - Fax:501-325-0197
Practice Address - Street 1:523 LOUISIANA ST
Practice Address - Street 2:, SUITE 211
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-5712
Practice Address - Country:US
Practice Address - Phone:501-951-2629
Practice Address - Fax:501-325-0197
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR329L101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)