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General NPI Number Information
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NPI Number | 1821901711
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Entity Type | Individual
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Provider Name | KAITLYN THOMA
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Gender | Female
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 3681 LEAPHART RD
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-3068
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Country | US
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Telephone | 803-479-3535
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Fax |
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Provider Business Mailing Address
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Address Line | 210 W WASHINGTON ST
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City | WINNSBORO
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State | SC
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Zip | 29180-1331
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Country | US
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Telephone | 803-801-0644
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | COU.11214PCI
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License Number State | SC
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