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NPI Code Detail

MEDICARE: CARRIE THOMAS, LLC

MEDICARE: CARRIE THOMAS, LLC
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 Worker2005014860MO

General Provider Information

NPI Number : 1609254093
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARRIE THOMAS, LLC
Provider Business Mailing Address
First Line : 1948 E ROSEBRIER ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-3800
Country : US
Telephone Number : 417-425-2907
Fax Number : 417-315-5393
Provider Business Practice Location Address
First Line : 1948 E ROSEBRIER ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-3800
Country : US
Telephone Number : 417-425-2907
Fax Number : 417-315-5393
Authorized Official
Title or Position : OWNER
Name : CARRIE E THOMAS
Credential : MSW, LCSW
Telephone Number : 417-425-2907
Provider Enumeration Date : 05/18/2015
Last Update Date : 05/18/2015

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Directions to “CARRIE THOMAS, LLC ” Practice Location

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