Provider Demographics
NPI:1982843942
Name:THOMAS, DEMETRA L (EDD, LPC-S)
Entity type:Individual
Prefix:DR
First Name:DEMETRA
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:F
Credentials:EDD, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-3620
Mailing Address - Country:US
Mailing Address - Phone:504-382-8314
Mailing Address - Fax:
Practice Address - Street 1:3301 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-3620
Practice Address - Country:US
Practice Address - Phone:504-382-8314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-16
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2896101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional