MEDICARE: MS. NANCY LOATMAN THOMAS LCSWR

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	PR039406-1	NY

General Provider Information

NPI Number	:	1801973292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY LOATMAN THOMAS LCSWR

Provider Business Mailing Address
First Line	:	1 ERVIN DR
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-3805
Country	:	US
Telephone Number	:	845-298-7293
Fax Number	:	845-297-7102

Provider Business Practice Location Address
First Line	:	1475 ROUTE 376
Second Line	:	STE F
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-6133
Country	:	US
Telephone Number	:	845-298-7293
Fax Number	:

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	10/31/2016

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