Thomas W. Wickham, L.P.C.
Individual provider Active NPI Counselor · Ingram, TX
NPI 1699832121 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1699832121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 18372 (TX)
- Practice address
- 321 Red Oak LN
Ingram, TX 78025-3616 - Phone
- (830) 377-8114
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 18372 | TX | Yes |
| Mental Health Counselor | 101YM0800X | 18372 | TX | |
| Professional Counselor | 101YP2500X | 18372 | TX |
Addresses
Primary practice location
321 Red Oak LN
Ingram, TX 78025-3616
Mailing address
321 Red Oak LN
Ingram, TX 78025-3616
Phone (830) 377-8114
Other providers in Ingram, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.