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NPI Code Detail

MEDICARE: KRISTEN TONI THOMAS LCSW

MEDICARE: KRISTEN TONI THOMAS LCSW
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
11041C0700XClinical Social WorkerSW25651FL

General Provider Information

NPI Number : 1083570790
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN TONI THOMAS LCSW
Provider Business Mailing Address
First Line : 145 WOODBRIDGE RD
Second Line :
City : KINGSLAND
State : GA
Zip : 31548-3373
Country : US
Telephone Number : 912-552-2040
Fax Number :
Provider Business Practice Location Address
First Line : 1201 ATLANTIC AVE
Second Line :
City : FERNANDINA BEACH
State : FL
Zip : 32034-3403
Country : US
Telephone Number : 912-552-2040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2025
Last Update Date : 12/27/2025

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