Provider Demographics
NPI:1831428234
Name:THOMAS COUNSELING
Entity type:Organization
Organization Name:THOMAS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:V
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-587-8707
Mailing Address - Street 1:3047 HUDSON CT
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-1115
Mailing Address - Country:US
Mailing Address - Phone:404-587-8707
Mailing Address - Fax:866-202-3087
Practice Address - Street 1:3781 PRESIDENTIAL PARKWAY
Practice Address - Street 2:SUITE 111C
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30035
Practice Address - Country:US
Practice Address - Phone:404-587-8707
Practice Address - Fax:866-202-3087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty