Provider Demographics
NPI:1588109607
Name:AMIE THOMAS LMHC LLC
Entity type:Organization
Organization Name:AMIE THOMAS LMHC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMIE
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:239-221-6370
Mailing Address - Street 1:9200 BONITA BEACH RD SE STE 210
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4278
Mailing Address - Country:US
Mailing Address - Phone:239-221-6370
Mailing Address - Fax:239-790-5185
Practice Address - Street 1:9200 BONITA BEACH RD SE STE 210
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4278
Practice Address - Country:US
Practice Address - Phone:239-221-6370
Practice Address - Fax:239-790-5185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-28
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9886101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001230800Medicaid