MEDICARE: DR. DEBBIE THOMAS LCSW, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	2620	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003930298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBBIE THOMAS LCSW, PHD

Provider Business Mailing Address
First Line	:	PO BOX 2101
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70602-2101
Country	:	US
Telephone Number	:	337-433-1111
Fax Number	:	337-433-1111

Provider Business Practice Location Address
First Line	:	1717 ILLINOIS ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-3706
Country	:	US
Telephone Number	:	337-433-1111
Fax Number	:	337-433-1111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	05/13/2014

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