Provider Demographics
NPI:1881225704
Name:THOMAS, AMANDA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2856 UNIVERSITY PKWY
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2410
Mailing Address - Country:US
Mailing Address - Phone:941-400-2624
Mailing Address - Fax:941-755-9357
Practice Address - Street 1:2856 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2410
Practice Address - Country:US
Practice Address - Phone:941-281-5553
Practice Address - Fax:941-755-9357
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17742101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701012815OtherSTATE LICENSE
FLMH17742OtherSTATE LICENSE
VT068.0134633TELEOtherSTATE LICENSE