Provider Demographics
NPI:1275418055
Name:THOMAS, D'JUAN DANIEL (MED, NCC, LPC-R)
Entity type:Individual
Prefix:MR
First Name:D'JUAN
Middle Name:DANIEL
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MED, NCC, LPC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 SHERBROOKE CIR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-7024
Mailing Address - Country:US
Mailing Address - Phone:757-912-1040
Mailing Address - Fax:
Practice Address - Street 1:3601 SHERBROOKE CIR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-7024
Practice Address - Country:US
Practice Address - Phone:757-912-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-09
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704018162101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health