Healthcare Provider Details

I. General information

NPI: 1851211270
Provider Name (Legal Business Name): HEATHER THOMAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 8TH AVE
TERRE HAUTE IN
47804-2771
US

IV. Provider business mailing address

620 8TH AVE
TERRE HAUTE IN
47804-2771
US

V. Phone/Fax

Practice location:
  • Phone: 812-231-8323
  • Fax: 812-231-8400
Mailing address:
  • Phone: 812-231-8242
  • Fax: 812-954-0127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34012948A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: