Individual provider Active NPI

Lacinda R Thomas, LPC

  • Professional Counselor
  • Johnson City, TN
National Provider Identifier
1780948034
Registry record updated Aug 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3451 Issued in TN
Practice address
2243 Eddie Williams Rd
Johnson City, TN 37601-2872
Phone
(423) 928-5627
Fax
(423) 928-4222
NPI assigned
Jul 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3451 TN Primary

Addresses

Primary practice location

2243 Eddie Williams Rd
Johnson City, TN 37601-2872

Mailing address

318 Corby Bridge Rd
Limestone, TN 37681-2733
Phone (423) 717-9362

Other practice location 1

2408 Susannah St Ste 1
Johnson City, TN 37601-1765
Phone (423) 434-6677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20241126003198 TN Practitioner - Mental Health Counselor 5395270482 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3451TNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Recovery, PLLC CurrentSince Jul 23, 2024 Accepting new patients
Frontier Health Past Accepting new patients

Locations

2408 Susannah St
Ste 1
Johnson City, TN 37601
Phone (423) 282-5054

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724544000000",
    "number": "1780948034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 CORBY BRIDGE RD",
            "city": "LIMESTONE",
            "state": "TN",
            "postal_code": "376812733",
            "telephone_number": "423-717-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2243 EDDIE WILLIAMS RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012872",
            "telephone_number": "423-928-5627",
            "fax_number": "423-928-4222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2408 Susannah St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376011765",
            "country_code": "US",
            "telephone_number": "423-434-6677",
            "fax_number": "423-461-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "LACINDA",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2024-08-25",
        "certification_date": "2024-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "3451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.