Provider Demographics
NPI:1093430787
Name:THOMAS, MEAGAN RENAE (LCSW)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:RENAE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 REDWOOD CREST LN
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1448
Mailing Address - Country:US
Mailing Address - Phone:940-613-1436
Mailing Address - Fax:
Practice Address - Street 1:3204 LONG PRAIRIE RD STE A
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4958
Practice Address - Country:US
Practice Address - Phone:940-613-1436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX621161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical