Provider Demographics
NPI:1306248125
Name:THOMAS, TREMISHA (MA, LPC-INTERN)
Entity type:Individual
Prefix:
First Name:TREMISHA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MA, LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 S FRY RD
Mailing Address - Street 2:SUITE 465
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:707 S FRY RD
Practice Address - Street 2:SUITE 465
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2256
Practice Address - Country:US
Practice Address - Phone:281-940-8515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71052101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health