MEDICARE: VIOLA THOMAS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CSW006502	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699041673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIOLA THOMAS LCSW

Provider Business Mailing Address
First Line	:	2870 PEACHTREE RD NW STE 915-8139
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2918
Country	:	US
Telephone Number	:	706-438-2276
Fax Number	:

Provider Business Practice Location Address
First Line	:	2870 PEACHTREE RD NW STE 915-8139
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2918
Country	:	US
Telephone Number	:	706-438-2276
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2012
Last Update Date	:	01/18/2022

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