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NPI Code Detail

MEDICARE: MR. THOMAS J SOWERS LCSW

MEDICARE: MR. THOMAS J SOWERS 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 WorkerLCSW-41171ID

General Provider Information

NPI Number : 1114431947
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS J SOWERS LCSW
Provider Business Mailing Address
First Line : 261 BUCKCAMP LN
Second Line :
City : MCCALL
State : ID
Zip : 83638-5092
Country : US
Telephone Number : 208-849-3079
Fax Number :
Provider Business Practice Location Address
First Line : PO BOX 748465
Second Line :
City : ATLANTA
State : GA
Zip : 30374-8465
Country : US
Telephone Number : 855-284-7483
Fax Number : 617-807-0958
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2017
Last Update Date : 12/09/2025

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