Provider Demographics
NPI: | 1033654041 |
---|---|
Name: | THOMAS, NORMA (LPCA, LPA, CVE, COTA) |
Entity type: | Individual |
Prefix: | |
First Name: | NORMA |
Middle Name: | |
Last Name: | THOMAS |
Suffix: | |
Gender: | F |
Credentials: | LPCA, LPA, CVE, COTA |
Other - Prefix: | |
Other - First Name: | NORMA |
Other - Middle Name: | |
Other - Last Name: | THOMAS |
Other - Suffix: | |
Other - Last Name Type: | Former Name |
Other - Credentials: | LPCA, LPA, CVE, COTA |
Mailing Address - Street 1: | 1939 GOLDSMITH LN STE 260 |
Mailing Address - Street 2: | |
Mailing Address - City: | LOUISVILLE |
Mailing Address - State: | KY |
Mailing Address - Zip Code: | 40218-3174 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 502-519-7979 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1939 GOLDSMITH LN STE 260 |
Practice Address - Street 2: | |
Practice Address - City: | LOUISVILLE |
Practice Address - State: | KY |
Practice Address - Zip Code: | 40218-3174 |
Practice Address - Country: | US |
Practice Address - Phone: | 502-519-7979 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2016-12-29 |
Last Update Date: | 2023-11-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
KY | 240438 | 103TC1900X |
KY | 171R00000X | |
KY | 251598 | 101YP2500X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | Professional |
No | 103TC1900X | Behavioral Health & Social Service Providers | Psychologist | Counseling |
No | 171R00000X | Other Service Providers | Interpreter |