Provider Demographics
NPI:1952933582
Name:THOMAS, ANNA (LMFT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 N MAIN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-3572
Mailing Address - Country:US
Mailing Address - Phone:630-480-9188
Mailing Address - Fax:
Practice Address - Street 1:999 N MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-3572
Practice Address - Country:US
Practice Address - Phone:630-480-9188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000798106H00000X
IL166.001664106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist