Healthcare Provider Details

I. General information

NPI: 1831903483
Provider Name (Legal Business Name): AMBER LURANA THOMAS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STONEFOREST DR STE 230
WOODSTOCK GA
30189-4903
US

IV. Provider business mailing address

100 STONEFOREST DR STE 230
WOODSTOCK GA
30189-4903
US

V. Phone/Fax

Practice location:
  • Phone: 678-314-0831
  • Fax:
Mailing address:
  • Phone: 470-552-8470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC013812
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: