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General NPI Number Information
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NPI Number | 1588177950
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Entity Type | Organization
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Legal Business Name | JOANNE S THOMAS LCSW PLLC
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3220 PEARL ST
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City | ENDWELL
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State | NY
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Zip | 13760-5758
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Country | US
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Telephone | 607-648-9249
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Fax | 877-935-6211
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Provider Business Mailing Address
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Address Line | 61 MATTHEW DR
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City | BINGHAMTON
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State | NY
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Zip | 13901-5748
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOANNE THOMAS
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Credential | LCSW-R
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Telephone | 607-648-9249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 055748
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License Number State | NY
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