Mary Logan Thomas, MS, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A2302005 Issued in AR

Practice address

34 W Colt Square Dr Ste 3
Fayetteville, AR 72703-2888

Phone

(479) 595-0333

NPI assigned

Feb 7, 2023

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1386341659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 AMBERWOOD ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620512",
            "telephone_number": "501-680-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 W COLT SQUARE DR STE 3",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032888",
            "telephone_number": "479-595-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MARY",
        "middle_name": "LOGAN",
        "credential": "MS, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "A2302005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna M Thomas, M.D.
• Jonathan Thomas, DO
• Julian Peter Beswick Thomas, LMSW
• Mandy Thomas
• Mark S. Thomas, M.D.
• Megan Thomas, BS, QBHP
• Patricia Thomas
• Rhagen Lynne Thomas, PA-C
• Tamela Thomas, RN
• Virginia Lee Thomas, M.D.

• Mental Health Counselor in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.