MEDICARE: THOMAS FAMILY AND BEHAVIORAL HEALTH SERVICES

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	363LF0000X	Family Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1477396000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS FAMILY AND BEHAVIORAL HEALTH SERVICES

Provider Business Mailing Address
First Line	:	1007 GOULD DR STE 3
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-4971
Country	:	US
Telephone Number	:	318-231-1127
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007 GOULD DR STE 1
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-4971
Country	:	US
Telephone Number	:	318-231-1127
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MRS. CONSTANCE GILLYARD THOMAS
Credential	:	PMHNP
Telephone Number	:	318-231-1127

Provider Enumeration Date	:	06/12/2024
Last Update Date	:	08/29/2025

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