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General NPI Number Information
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NPI Number | 1568034635
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Entity Type | Individual
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Provider Name | THOMAS CLOUSE LPC
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Gender | Male
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 7977 W WACKER RD UNIT 231
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City | PEORIA
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State | AZ
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Zip | 85381-4070
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Country | US
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Telephone | 480-387-8395
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Fax |
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Provider Business Mailing Address
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Address Line | 7977 W WACKER RD UNIT 231
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City | PEORIA
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State | AZ
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Zip | 85381-4070
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Country | US
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Telephone | 480-387-8395
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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 |
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 19746
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License Number State | AZ
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