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General NPI Number Information
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NPI Number | 1740581164
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Entity Type | Individual
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Provider Name | TASHIMA THOMAS LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 11/17/2010
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 1233 THE PLZ UNIT 5030
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City | CHARLOTTE
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State | NC
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Zip | 28299-2201
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Country | US
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Telephone | 980-515-3704
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5030
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City | CHARLOTTE
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State | NC
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Zip | 28299-2201
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Country | US
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Telephone | 443-219-7878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 075317
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License Number State | NY
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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 | 0904008556
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C018754
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 18279
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License Number State | MD
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