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NPI Code Detail

MEDICARE: LAKEISHA D THOMAS LLMSW

MEDICARE: LAKEISHA D THOMAS LLMSW
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 Worker6801105180MI

General Provider Information

NPI Number : 1386232759
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAKEISHA D THOMAS LLMSW
Provider Business Mailing Address
First Line : 813 E MICHIGAN AVE STE 201
Second Line :
City : YPSILANTI
State : MI
Zip : 48198-5801
Country : US
Telephone Number : 734-799-6033
Fax Number :
Provider Business Practice Location Address
First Line : 813 E MICHIGAN AVE STE 201
Second Line :
City : YPSILANTI
State : MI
Zip : 48198-5801
Country : US
Telephone Number : 734-288-8097
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/01/2021
Last Update Date : 05/03/2024

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Directions to “ LAKEISHA D THOMAS LLMSW” Practice Location

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