Provider Demographics
NPI:1356350813
Name:ALLEN, THOMAS (MED, LPC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:MED, LPC
Other - Prefix:
Other - First Name:THOM
Other - Middle Name:
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED
Mailing Address - Street 1:1900 PRESTON RD STE 267
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3604
Mailing Address - Country:US
Mailing Address - Phone:972-731-2656
Mailing Address - Fax:
Practice Address - Street 1:5465 LEGACY DR STE 650
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4171
Practice Address - Country:US
Practice Address - Phone:972-731-2656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15607101Y00000X, 101YP2500X
TX15067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health