Provider Demographics
NPI:1912144833
Name:THURMOND, ERIC C (LPC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:C
Last Name:THURMOND
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 1:318 BLUE RIDGE GAP RD
Mailing Address - Street 2:
Mailing Address - City:RABUN GAP
Mailing Address - State:GA
Mailing Address - Zip Code:30568-2919
Mailing Address - Country:US
Mailing Address - Phone:706-614-4786
Mailing Address - Fax:855-945-3795
Practice Address - Street 1:69 SEED TICK RD
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-5988
Practice Address - Country:US
Practice Address - Phone:706-614-4786
Practice Address - Fax:855-945-3795
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
GALPC005864101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health