Individual
ILYASAH JA'KILLA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHCA
Contact information
Practice address
5821 FAIRVIEW RD STE 101, CHARLOTTE, NC 28209-5601
(980) 308-4500
(980) 458-6037
Mailing address
13309 HUNTING BIRDS LN, CHARLOTTE, NC 28278-8783
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A22784
NC
Other
Enumeration date
04/07/2026
Last updated
04/22/2026
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