Healthcare Provider Details

I. General information

NPI: 1245176379
Provider Name (Legal Business Name): MRS. CARRY ANN THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 VISTA BLVD STE 106
SPARKS NV
89436-6705
US

IV. Provider business mailing address

3080 VISTA BLVD STE 106
SPARKS NV
89436-6705
US

V. Phone/Fax

Practice location:
  • Phone: 775-393-9212
  • Fax: 775-799-2043
Mailing address:
  • Phone: 775-393-9212
  • Fax: 775-799-2043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: