Healthcare Provider Details

I. General information

NPI: 1285612713
Provider Name (Legal Business Name): THOMAS EVERETT MCDANIEL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 05/31/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 TUNNEL RD
ASHEVILLE NC
28805-2576
US

IV. Provider business mailing address

PO BOX 334
MORGANTON NC
28680-0334
US

V. Phone/Fax

Practice location:
  • Phone: 828-202-2735
  • Fax:
Mailing address:
  • Phone: 704-929-8712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC003601
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: