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NPI Code Detail

MEDICARE: JACQUELINE REEVES THOMAS LPC

MEDICARE:   JACQUELINE REEVES THOMAS  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC0000004507TN

General Provider Information

NPI Number : 1477195451
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE REEVES THOMAS LPC
Provider Business Mailing Address
First Line : 2860 GOOSE CREEK DR APT 103
Second Line :
City : CORDOVA
State : TN
Zip : 38016-1834
Country : US
Telephone Number : 301-613-5064
Fax Number :
Provider Business Practice Location Address
First Line : MEMPHIS VETERANS AFFAIRS MEDICAL CENTER (VAMC)
Second Line : 1030 JEFFERSON AVE
City : MEMPHIS
State : TN
Zip : 38016
Country : US
Telephone Number : 901-523-8990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2019
Last Update Date : 11/27/2023

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Directions to “ JACQUELINE REEVES THOMAS LPC” Practice Location

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