Provider Demographics
NPI:1972730596
Name:THOMAS, STEPHNIE M (MS, NCC, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHNIE
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS, NCC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 E MAIN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5037
Mailing Address - Country:US
Mailing Address - Phone:410-236-1470
Mailing Address - Fax:410-751-2090
Practice Address - Street 1:77 E MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5037
Practice Address - Country:US
Practice Address - Phone:410-236-1470
Practice Address - Fax:410-751-2090
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC240153 (NBCC)101Y00000X
MDLC4083101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD441708900Medicaid