Provider Demographics
NPI:1881651925
Name:THOMAS T. LAWSON, PH.D. PA
Entity Type:Organization
Organization Name:THOMAS T. LAWSON, PH.D. PA
Other - Org Name:CENTER FOR PSYCHOLOGY & COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:T
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:479-444-1400
Mailing Address - Street 1:118 E SUNBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2830
Mailing Address - Country:US
Mailing Address - Phone:479-444-1400
Mailing Address - Fax:479-444-1422
Practice Address - Street 1:118 E SUNBRIDGE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2830
Practice Address - Country:US
Practice Address - Phone:479-444-1400
Practice Address - Fax:479-444-1422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5F382OtherBLUE CROSS BLUE SHIELD