# ELAINE A THOMAS PSYD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447584578
- **Authorized official:** DR. ELAINE ANGELA THOMAS PSY.D. (LICENSED PSYCHOLOGIST/OWNER)
- **Authorized official phone:** (770) 216-0460

## Contact information

- **Practice address:** 316 ALEXANDER ST SE, SUITE 6, MARIETTA, GA 30060-8217
- **Practice address phone:** (770) 216-0460
- **Practice address fax:** (678) 581-0146
- **Mailing address:** 316 ALEXANDER ST SE, SUITE 6, MARIETTA, GA 30060-8217
- **Mailing address phone:** (770) 216-0460
- **Mailing address fax:** (678) 581-0146

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TB0200X | Cognitive & Behavioral Psychologist | PSY\#2936 | GA | — |
| 103TC0700X | Clinical Psychologist | PSY\#2936 | GA | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | PSY\#2936 | GA | Yes |

## Other

- **Enumeration date:** 09/22/2009
- **Last updated:** 03/17/2010