Individual
COURTNEY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCASA
Contact information
Practice address
351 WAGONER DR STE 318, FAYETTEVILLE, NC 28303-4739
(859) 420-8043
Mailing address
910 HOPE MILLS RD, FAYETTEVILLE, NC 28304-4243
(910) 302-8290
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-16017
NC
1041C0700X
Clinical Social Worker
Primary
C009768
NC
Other
Enumeration date
09/20/2013
Last updated
02/08/2021
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