| Doctor Name: | MR. MATTHEW R THAMES |
| NPI Number: | 1083821326 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.A., LPC |
| License Number: | 1119 |
| Business Practice Address: | 2508 Lakeland Dr Suite 200 Flowood, MS - 392329502 |
| Business Phone Number: | 6016640455 |
| Business Fax Number: | 6016641675 |
| Mailing Address: | 903 Post Rd, CLINTON |
| State: | MS |
| Postal Code: | 390563839 |
| Phone Number: | 6017508977 |
| Fax Number: | |
| NPI Enumeration Date: | 05/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1119 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |