MEDICARE: MRS. SANDY LYNN THOMAS LCPC

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	1311	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508902644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDY LYNN THOMAS LCPC

Provider Business Mailing Address
First Line	:	68 BIG BEND LN
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-6446
Country	:	US
Telephone Number	:	406-453-4457
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 2ND AVE N
Second Line	:	SUITE 430
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-3259
Country	:	US
Telephone Number	:	406-771-8182
Fax Number	:	406-771-3948

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/09/2007

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