MEDICARE: JENNIFER NICOLE THOMAS

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
1	101YM0800X	Mental Health Counselor	101744	TX

General Provider Information

NPI Number	:	1811839863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER NICOLE THOMAS

Provider Business Mailing Address
First Line	:	17427 COVENTRY OAKS DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-6671
Country	:	US
Telephone Number	:	832-858-2004
Fax Number	:

Provider Business Practice Location Address
First Line	:	3131 EASTSIDE ST STE 415
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-1919
Country	:	US
Telephone Number	:	281-948-3322
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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