Provider Demographics
NPI:1750786687
Name:THOMAS, PATRICIA (LCDC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 FOREST PINES CT
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5179
Mailing Address - Country:US
Mailing Address - Phone:281-827-3054
Mailing Address - Fax:
Practice Address - Street 1:421 FOREST PINES CT
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5179
Practice Address - Country:US
Practice Address - Phone:281-827-3054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12509101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)