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General NPI Number Information
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NPI Number | 1558521906
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Entity Type | Individual
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Provider Name | CLARENCE THOMAS LPC, LMFT
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Gender | Male
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 1162 OLIVER RD STE 4
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City | MONROE
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State | LA
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Zip | 71201-5757
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Country | US
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Telephone | 318-340-1535
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Fax | 318-340-1539
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Provider Business Mailing Address
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Address Line | 1162 OLIVER RD STE 4
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City | MONROE
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State | LA
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Zip | 71201-5757
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Country | US
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Telephone | 318-340-1535
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Fax | 318-340-1539
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2447
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 410
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License Number State | LA
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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 | 2447
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License Number State | LA
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