Provider Demographics
NPI:1013567684
Name:THOMAS, AMIE HOPE
Entity type:Individual
Prefix:
First Name:AMIE
Middle Name:HOPE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4031 112TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-6749
Mailing Address - Country:US
Mailing Address - Phone:475-318-0929
Mailing Address - Fax:
Practice Address - Street 1:4031 112TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-6749
Practice Address - Country:US
Practice Address - Phone:475-318-0929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-16
Last Update Date:2025-09-25
Deactivation Date:2025-04-05
Deactivation Code:
Reactivation Date:2025-09-25
Provider Licenses
StateLicense IDTaxonomies
TX77643101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty