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General NPI Number Information
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NPI Number | 1083944979
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Entity Type | Organization
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Legal Business Name | MACTHOMAS & COMPANY
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Dates
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Enumeration Date | 12/28/2009
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 508 ACADEMY AVE
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City | DUBLIN
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State | GA
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Zip | 31021-5202
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Country | US
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Telephone | 478-274-2425
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 16549
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City | DUBLIN
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State | GA
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Zip | 31040-6549
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Country | US
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Telephone | 478-274-2425
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | MS. JOY C MACTHOMAS
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Credential | LCSW
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Telephone | 478-274-2425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MASTER ADDICTION
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW003282
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License Number State | GA
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