Individual
SCOTT WILLIAM THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1814 S MAIN ST, BROKEN ARROW, OK 74012-6503
(918) 991-5771
Mailing address
6369 S 86TH EAST AVE, TULSA, OK 74133-1356
(918) 991-5771
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
Primary
1492
OK
106H00000X
Marriage & Family Therapist
722
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1492
OKLAHOMA STATE DEPARTMENT OF HEALTH/LPC LICENSE
OK
01
—
722
OKLAHOMA STATE DEPARTMENT OF HEALTH/LMFT LICENSE
OK
Enumeration date
07/11/2013
Last updated
07/11/2013
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