Healthcare Provider Details

I. General information

NPI: 1467184796
Provider Name (Legal Business Name): ALICIA ANNE THOMAS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 NEW HANOVER MEDICAL PARK DR
WILMINGTON NC
28403-5345
US

IV. Provider business mailing address

PO BOX 936857
ATLANTA GA
31193-6857
US

V. Phone/Fax

Practice location:
  • Phone: 910-662-9300
  • Fax: 910-662-2401
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP017724
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC020137
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: