Provider Demographics
NPI:1922631126
Name:THOMAS, PATRICE DELAYNE (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICE
Middle Name:DELAYNE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SUMMIT PKWY STE 107C
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4741
Mailing Address - Country:US
Mailing Address - Phone:205-704-1181
Mailing Address - Fax:
Practice Address - Street 1:120 SUMMIT PKWY STE 107C
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-4741
Practice Address - Country:US
Practice Address - Phone:205-704-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-15
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0850X
AL3632101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health