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NPI Code Detail

MEDICARE: SHAWNA D THOMERSON MSW, CSW

MEDICARE: SHAWNA D THOMERSON MSW, CSW
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
1104100000XSocial Worker2636KY

General Provider Information

NPI Number : 1457407793
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWNA D THOMERSON MSW, CSW
Provider Business Mailing Address
First Line : 1095 IROQUOIS DR
Second Line :
City : MOUNT STERLING
State : KY
Zip : 40353-8133
Country : US
Telephone Number : 859-498-8664
Fax Number :
Provider Business Practice Location Address
First Line : 400 PROFESSIONAL AVE
Second Line :
City : WINCHESTER
State : KY
Zip : 40391-1147
Country : US
Telephone Number : 859-744-4482
Fax Number : 858-737-2426
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2007
Last Update Date : 07/08/2007

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