Provider Demographics
NPI:1902682586
Name:THOMAS, CRISTI (LPC)
Entity type:Individual
Prefix:
First Name:CRISTI
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 BRIARCLIFF TRL
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-7634
Mailing Address - Country:US
Mailing Address - Phone:325-245-3845
Mailing Address - Fax:325-442-9850
Practice Address - Street 1:4745 BRIARCLIFF TRL
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-7634
Practice Address - Country:US
Practice Address - Phone:325-245-3845
Practice Address - Fax:325-442-9850
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89226101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty