Provider Demographics
NPI:1891087045
Name:THOMAS, BONNIE LYNNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:LYNNE
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 1:415 N MCKINLEY ST
Mailing Address - Street 2:STE. 500
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3013
Mailing Address - Country:US
Mailing Address - Phone:501-664-6632
Mailing Address - Fax:501-664-1441
Practice Address - Street 1:415 N MCKINLEY ST
Practice Address - Street 2:STE. 500
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-3013
Practice Address - Country:US
Practice Address - Phone:501-664-6632
Practice Address - Fax:501-664-1441
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1005032101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional