Provider Demographics
NPI:1912043324
Name:THOMAS, CINDY ANN (LAC, CCGC)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:ANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LAC, CCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6005 FINANCIAL PLZ
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71129-2615
Mailing Address - Country:US
Mailing Address - Phone:318-632-2040
Mailing Address - Fax:318-632-2073
Practice Address - Street 1:6005 FINANCIAL PLZ
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129-2615
Practice Address - Country:US
Practice Address - Phone:318-632-2040
Practice Address - Fax:318-632-2073
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALAC# 897101YA0400X
LACCGC#130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)