Healthcare Provider Details

I. General information

NPI: 1396247565
Provider Name (Legal Business Name): GAIL THOMAS LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2018
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 CIVIC CENTER BLVD
HOUMA LA
70360-5937
US

IV. Provider business mailing address

214 WOODBURN DR
HOUMA LA
70364-2383
US

V. Phone/Fax

Practice location:
  • Phone: 985-860-4631
  • Fax:
Mailing address:
  • Phone: 985-860-4631
  • Fax: 985-526-6732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number5536
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5536
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: