Provider Demographics
NPI:1770265852
Name:THOMAS, JILLIAN LAMAE
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:LAMAE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12103 OAKWOOD VIEW DR APT 306
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-6880
Mailing Address - Country:US
Mailing Address - Phone:919-671-2169
Mailing Address - Fax:
Practice Address - Street 1:120 TOWERVIEW CT
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-3595
Practice Address - Country:US
Practice Address - Phone:919-585-5085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health