Provider Demographics
NPI:1538556931
Name:THOMAS, DOUGLAS ALTON (LPC, LMHC)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:ALTON
Last Name:THOMAS
Suffix:
Gender:X
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC, LMHC
Mailing Address - Street 1:6415 23RD ST S APT 419
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-6307
Mailing Address - Country:US
Mailing Address - Phone:412-475-9601
Mailing Address - Fax:
Practice Address - Street 1:6415 23RD ST S APT 419
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-6307
Practice Address - Country:US
Practice Address - Phone:412-475-9601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002591A101YM0800X
101YP2500X
PAPC007549101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health