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General NPI Number Information
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NPI Number | 1770997645
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Entity Type | Individual
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Provider Name | MARK WHITNEY THOMAS LCSW
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Gender | Male
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Dates
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Enumeration Date | 06/18/2014
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 305 RODGERS DR
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City | SEARCY
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State | AR
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Zip | 72143-7432
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Country | US
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Telephone | 501-203-0857
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Fax | 501-203-0861
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Provider Business Mailing Address
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Address Line | PO BOX 497
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City | AUGUSTA
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State | AR
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Zip | 72006-0497
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Country | US
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Telephone | 870-347-2534
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Fax | 870-301-2092
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | AR
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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 | 7279C
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License Number State | AR
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