Individual
MR. THORN T PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
23363 S ROBIN RD # QUADB, MANDEVILLE, LA 70448-7381
(985) 624-4118
(985) 690-6662
Mailing address
23363 S ROBIN RD # QUADB, MANDEVILLE, LA 70448-7381
(985) 624-4118
(985) 624-4123
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LPC7769
LA
101YP2500X
Professional Counselor
LPC7769
LA
101YP2500X
Professional Counselor
PLC7769
LA
171M00000X
Case Manager/Care Coordinator
LPC7769
LA
171M00000X
Case Manager/Care Coordinator
PLC7769
LA
Other
Enumeration date
04/08/2021
Last updated
02/08/2024
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