Medina Diane Thomas, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

94719 Issued in TX

Practice address

2435 College Dr
Texarkana, TX 75501-2788

Phone

(800) 446-8253

Fax

(903) 234-1639

NPI assigned

Jan 5, 2026

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sabine Valley Regional MHMR Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longview, TX
  • NPI 1639232002
  Medicare reassignment
• Sabine Valley Regional MHMR Center

  • Family Medicine Physician
  • Longview, TX
  • NPI 1841835022
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1767571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767571200000",
    "number": "1285591149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WOODBINE PL",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756012912",
            "telephone_number": "903-758-2471",
            "fax_number": "903-234-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 COLLEGE DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755012788",
            "telephone_number": "800-446-8253",
            "fax_number": "903-234-1639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MEDINA",
        "middle_name": "DIANE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-01-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "94719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Freda Shavon Thomas, LCSW
• Jeffory Ford Thomas, MD
• Jonathan F Thomas, MD
• Katelyn Victoria Thomas, OTR
• Kristie Lynn Thomas, FNP-C
• Alan Michael Thomason, PHARMD
• Kaitlyn Alice Thomason, PA-C
• Randy Ervin Thomason Jr., LCDC, LPC
• Sheila Michele Thomason
• Douglas Thompson, MD

• Professional Counselor in Texarkana, TX
• Providers in Texarkana, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.