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General NPI Number Information
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NPI Number | 1881938785
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Entity Type | Individual
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Provider Name | THOMAS CLIFTON ESTIS PHD
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Gender | Male
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | 1106 STUBBS AVENUE SUITE B
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City | MONROE
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State | LA
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Zip | 71211
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Country | US
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Telephone | 318-237-5741
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Fax | 318-816-5332
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Provider Business Mailing Address
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Address Line | 1106 STUBBS AVENUE SUITE B
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City | MONROE
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State | LA
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Zip | 71211
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Country | US
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Telephone | 318-237-5741
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Fax | 318-816-5332
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 758
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License Number State | LA
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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 | 1870
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 107
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License Number State | LA
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