Healthcare Provider Details

I. General information

NPI: 1306267943
Provider Name (Legal Business Name): YARONA THOMAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2013
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N. MCNEILL ST. UNIT 4
CARTHAGE NC
28327
US

IV. Provider business mailing address

303 N. MCNEILL ST. UNIT 4
CARTHAGE NC
28327
US

V. Phone/Fax

Practice location:
  • Phone: 910-722-2202
  • Fax:
Mailing address:
  • Phone: 910-722-2202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: YARONA V THOMAS
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 910-722-2202