Provider Demographics
NPI:1972263101
Name:DANA A. THOMASON PA
Entity Type:Organization
Organization Name:DANA A. THOMASON PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:A
Authorized Official - Last Name:THOMASON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, CCMHC
Authorized Official - Phone:479-264-1241
Mailing Address - Street 1:2027 S VERONA AVE
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72802-2703
Mailing Address - Country:US
Mailing Address - Phone:479-264-1241
Mailing Address - Fax:
Practice Address - Street 1:910 S ROGERS ST STE B
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-4331
Practice Address - Country:US
Practice Address - Phone:479-264-1241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty