Provider Demographics
NPI:1780293829
Name:THOMAS, LEAH COLEMAN (LCMHC, MAC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:COLEMAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCMHC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 SALISBURY RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-3824
Mailing Address - Country:US
Mailing Address - Phone:804-897-3764
Mailing Address - Fax:
Practice Address - Street 1:2510 SALISBURY RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-3824
Practice Address - Country:US
Practice Address - Phone:804-897-3764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2706101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional