Healthcare Provider Details

I. General information

NPI: 1215583034
Provider Name (Legal Business Name): PIERRE NICOLAU THOMAS LICSW, LCSW-C, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 GREENLOW RD
CATONSVILLE MD
21228-1838
US

IV. Provider business mailing address

430 GREENLOW RD
CATONSVILLE MD
21228-1838
US

V. Phone/Fax

Practice location:
  • Phone: 443-336-2573
  • Fax:
Mailing address:
  • Phone: 443-336-2573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22151
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904012825
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50082176
License Number StateDC
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05958500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: