Healthcare Provider Details

I. General information

NPI: 1275219347
Provider Name (Legal Business Name): CAROLINE THOMAS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 PROFESSIONAL RD STE A
NORTH CHESTERFIELD VA
23235-3267
US

IV. Provider business mailing address

PO BOX 8294
RICHMOND VA
23226-0294
US

V. Phone/Fax

Practice location:
  • Phone: 804-991-0359
  • Fax:
Mailing address:
  • Phone: 804-991-0359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701011997
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: