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General NPI Number Information
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NPI Number | 1093994949
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Entity Type | Individual
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Provider Name | KEYONA SHANTRICE THOMAS PSY.D., MA, LCPC
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Gender | Female
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 09/01/2025
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Provider Practice Location Address
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Address Line | 9701 APOLLO DR STE 100
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City | LARGO
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State | MD
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Zip | 20774-4785
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Country | US
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Telephone | 240-283-5595
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Fax |
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Provider Business Mailing Address
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Address Line | 9701 APOLLO DR STE 100
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City | LARGO
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State | MD
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Zip | 20774-4785
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Country | US
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Telephone | 240-283-5595
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC2555
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PRC13986
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701008086
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810007740
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY200001288
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License Number State | DC
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Taxonomy #6
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 07013
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License Number State | MD
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