1508902644 NPI number — MRS. SANDY LYNN THOMAS LCPC

Table of content: MRS. SANDY LYNN THOMAS LCPC (NPI 1508902644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508902644 NPI number — MRS. SANDY LYNN THOMAS LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THOMAS
Provider First Name:
SANDY
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TOMSHECK
Provider Other First Name:
SANDY
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1508902644
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
68 BIG BEND LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREAT FALLS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59404-6446
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-453-4457
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 2ND AVE N
Provider Second Line Business Practice Location Address:
SUITE 430
Provider Business Practice Location Address City Name:
GREAT FALLS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59401-3259
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-771-8182
Provider Business Practice Location Address Fax Number:
406-771-3948
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  1311 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0255374 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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