Provider Demographics
NPI:1699898734
Name:PICA-THOMAS, PATRICIA ELAINE (LMHC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ELAINE
Last Name:PICA-THOMAS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HARVEST LANE
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:MA
Mailing Address - Zip Code:02338-1651
Mailing Address - Country:US
Mailing Address - Phone:781-293-6181
Mailing Address - Fax:
Practice Address - Street 1:235 N PEARL ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1794
Practice Address - Country:US
Practice Address - Phone:508-427-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA48691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical