Individual
LISSETH CARMEN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3020 HAMAKER CT, FAIRFAX, VA 22031-2238
(703) 204-0085
Mailing address
3020 HAMAKER CT, FAIRFAX, VA 22031-2238
(440) 600-8983
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810008585
VA
103TC0700X
Clinical Psychologist
PSY-1230
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/13/2008
Last updated
07/23/2025
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