MEDICARE: CHRISTINA THOMAS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	64010105644	MI
2	101YP2500X	Professional Counselor	0012999	CO
3	101YP2500X	Professional Counselor	0701006970	VA

General Provider Information

NPI Number	:	1083115703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA THOMAS LPC

Provider Business Mailing Address
First Line	:	13313 LADY ASHLEY RD
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23114-4539
Country	:	US
Telephone Number	:	720-277-7746
Fax Number	:

Provider Business Practice Location Address
First Line	:	804 MOOREFIELD PARK DR STE 204
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-3670
Country	:	US
Telephone Number	:	720-277-7746
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2018
Last Update Date	:	11/11/2023

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Directions to “ CHRISTINA THOMAS LPC” Practice Location

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