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NPI Code Detail

MEDICARE: KOURTNEY THOMASON LLMSW

MEDICARE: KOURTNEY THOMASON LLMSW
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 Worker6851116083MI

General Provider Information

NPI Number : 1831881309
Entity Type Code : Individual
Provider Name (Legal Business Name) : KOURTNEY THOMASON LLMSW
Provider Business Mailing Address
First Line : 5505 CORPORATE DR
Second Line :
City : TROY
State : MI
Zip : 48098-2614
Country : US
Telephone Number : 248-509-1924
Fax Number :
Provider Business Practice Location Address
First Line : 5505 CORPORATE DR
Second Line :
City : TROY
State : MI
Zip : 48098-2614
Country : US
Telephone Number : 248-509-1924
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2023
Last Update Date : 05/23/2023

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Directions to “ KOURTNEY THOMASON LLMSW” Practice Location

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