| Laura Thomas, Llc | |
|
4720 Pagosa Springs Cir Melbourne FL 32901-8255 | |
| (205) 657-1765 | |
| Not Available |
| Full Name | Laura Thomas, Llc |
|---|---|
| Speciality | Counselor |
| Location | 4720 Pagosa Springs Cir, Melbourne, Florida |
| Authorized Official Name and Position | Laura Thomas (OWNER/PROVIDER) |
| Authorized Official Contact | 2056571765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Laura Thomas, Llc 4720 Pagosa Springs Cir Melbourne FL 32901-8255 Ph: (205) 657-1765 | Laura Thomas, Llc 4720 Pagosa Springs Cir Melbourne FL 32901-8255 Ph: (205) 657-1765 |
| NPI Number | 1023700184 |
|---|---|
| Provider Enumeration Date | 05/25/2023 |
| Last Update Date | 03/12/2025 |
| Certification Date | 03/12/2025 |
| Medicare PECOS PAC ID | 2163861238 |
|---|---|
| Medicare Enrollment ID | O20240423000434 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023700184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Laura Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932774973 PECOS PAC ID: 4486054079 Enrollment ID: I20210618001731 |
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