MEDICARE: LAHAJI THOMAS

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
1	1041S0200X	School Social Worker
2	1041C0700X	Clinical Social Worker	149.028226	IL

General Provider Information

NPI Number	:	1689255085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAHAJI THOMAS

Provider Business Mailing Address
First Line	:	8383 MIDLAND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63114-5926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 MARKET ST STE 110
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63101-1824
Country	:	US
Telephone Number	:	773-600-6667
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2021
Last Update Date	:	06/07/2025

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Directions to “ LAHAJI THOMAS ” Practice Location

Language	Start Address	Practice Location

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