MEDICARE: MRS. AMY M. THOMAS-HARMON LCSW

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	1041C0700X	Clinical Social Worker	0904005565	VA

General Provider Information

NPI Number	:	1770532475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY M. THOMAS-HARMON LCSW

Provider Business Mailing Address
First Line	:	7609 TANGLEWOOD RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-1150
Country	:	US
Telephone Number	:	804-519-0016
Fax Number	:

Provider Business Practice Location Address
First Line	:	6962 FOREST HILL AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-1606
Country	:	US
Telephone Number	:	804-519-0016
Fax Number	:

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

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	07/08/2007

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