Provider Demographics
NPI:1013507771
Name:THOMAS, EMILY JO (LMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JO
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2312 JOHNSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-2723
Mailing Address - Country:US
Mailing Address - Phone:530-701-3209
Mailing Address - Fax:
Practice Address - Street 1:3630 S PLAZA TRL
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-3300
Practice Address - Country:US
Practice Address - Phone:757-797-4086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0730000412106H00000X
VA0717001795106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist