Provider Demographics
NPI:1942717582
Name:THOMAS, CHRISTINA (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
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 1:4425 S MOPAC EXPY, STE 502
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6707
Mailing Address - Country:US
Mailing Address - Phone:512-768-8850
Mailing Address - Fax:
Practice Address - Street 1:4425 SOUTH MOPAC EXPRESSWAY
Practice Address - Street 2:# 502
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735
Practice Address - Country:US
Practice Address - Phone:512-768-8850
Practice Address - Fax:844-839-5423
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2022-08-23
Deactivation Date:2020-08-02
Deactivation Code:
Reactivation Date:2022-08-23
Provider Licenses
StateLicense IDTaxonomies
TX70658101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health