Healthcare Provider Details

I. General information

NPI: 1316921950
Provider Name (Legal Business Name): DEBORAH J THOMAS MA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 N 15TH AVE
LEBANON PA
17046
US

IV. Provider business mailing address

200 NORTH 7TH ST
LEBANON PA
17046
US

V. Phone/Fax

Practice location:
  • Phone: 717-274-9682
  • Fax: 717-274-9549
Mailing address:
  • Phone: 717-273-1710
  • Fax: 717-273-1416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCO3404
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number003503PA
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC03404
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number003503PA
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: