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NPI Code Detail

MEDICARE: LISA THOMAS-PAM M.A.

MEDICARE:   LISA  THOMAS-PAM  M.A.
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
1101YM0800XMental Health Counselor

Other Identifiers

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

General Provider Information

NPI Number : 1598949463
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA THOMAS-PAM M.A.
Provider Business Mailing Address
First Line : 613 MARQUETTE RD
Second Line :
City : BRANDON
State : MS
Zip : 39042-3038
Country : US
Telephone Number : 601-825-8800
Fax Number : 601-825-8800
Provider Business Practice Location Address
First Line : 613 MARQUETTE RD
Second Line :
City : BRANDON
State : MS
Zip : 39042-3038
Country : US
Telephone Number : 601-825-8800
Fax Number : 601-824-1681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2007
Last Update Date : 08/27/2024

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Directions to “ LISA THOMAS-PAM M.A.” Practice Location

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