Provider Demographics
NPI:1780948034
Name:THOMAS, LACINDA R (LPC)
Entity type:Individual
Prefix:
First Name:LACINDA
Middle Name:R
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 CORBY BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LIMESTONE
Mailing Address - State:TN
Mailing Address - Zip Code:37681-2733
Mailing Address - Country:US
Mailing Address - Phone:423-717-9362
Mailing Address - Fax:
Practice Address - Street 1:2243 EDDIE WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-2872
Practice Address - Country:US
Practice Address - Phone:423-928-5627
Practice Address - Fax:423-928-4222
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2024-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3451101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional