Provider Demographics
NPI:1386240497
Name:THOMAS, TWANA JOY (LPC-I)
Entity type:Individual
Prefix:
First Name:TWANA
Middle Name:JOY
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 GARDEN PATH DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-6811
Mailing Address - Country:US
Mailing Address - Phone:765-603-3567
Mailing Address - Fax:
Practice Address - Street 1:8700 MENCHACA RD STE 202
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-5373
Practice Address - Country:US
Practice Address - Phone:765-603-3567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX84875101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor