Provider Demographics
NPI:1588428080
Name:HELTON, THOMAS STACY (LPC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:STACY
Last Name:HELTON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 E DAYTONA DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-2412
Mailing Address - Country:US
Mailing Address - Phone:423-310-6169
Mailing Address - Fax:
Practice Address - Street 1:3 E DAYTONA DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-2412
Practice Address - Country:US
Practice Address - Phone:423-310-6169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014977101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health