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NPI Code Detail

MEDICARE: MR. THOMAS JOSEPH HIMSCHOOT MSW

MEDICARE:  MR. THOMAS JOSEPH HIMSCHOOT  MSW
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 Worker34000995IN

General Provider Information

NPI Number : 1588875611
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS JOSEPH HIMSCHOOT MSW
Provider Business Mailing Address
First Line : 701 N MASON ST
Second Line :
City : MISHAWAKA
State : IN
Zip : 46544-2409
Country : US
Telephone Number : 574-259-0779
Fax Number :
Provider Business Practice Location Address
First Line : 818 E JEFFERSON BLVD
Second Line :
City : SOUTH BEND
State : IN
Zip : 46617-2905
Country : US
Telephone Number : 574-287-1879
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2007
Last Update Date : 07/08/2007

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Directions to “ MR. THOMAS JOSEPH HIMSCHOOT MSW” Practice Location

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