MEDICARE: MEAGAN RENAE 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
1	1041C0700X	Clinical Social Worker	62116	TX

General Provider Information

NPI Number	:	1093430787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEAGAN RENAE THOMAS LCSW

Provider Business Mailing Address
First Line	:	1529 REDWOOD CREST LN
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-1448
Country	:	US
Telephone Number	:	940-613-1436
Fax Number	:

Provider Business Practice Location Address
First Line	:	3204 LONG PRAIRIE RD STE A
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-4958
Country	:	US
Telephone Number	:	940-613-1436
Fax Number	:

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

Provider Enumeration Date	:	10/05/2022
Last Update Date	:	10/05/2022

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