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NPI Code Detail

MEDICARE: TODD M THOMAS M.A.

MEDICARE: TODD M THOMAS M.A.
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
1104100000XSocial Worker8581-123WI
2106H00000XMarriage & Family Therapist1127-124WI

General Provider Information

NPI Number : 1932452448
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD M THOMAS M.A.
Provider Business Mailing Address
First Line : 1622 N 48TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53208-2247
Country : US
Telephone Number : 414-200-9275
Fax Number : 414-200-9276
Provider Business Practice Location Address
First Line : 1622 N 48TH ST
Second Line :
City : MILWAUKEE
State : WI
Zip : 53208-2247
Country : US
Telephone Number : 414-200-9275
Fax Number : 414-200-9276
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2012
Last Update Date : 02/09/2026

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