Provider Demographics
NPI:1194925404
Name:THOMAS, VELISKA JOY (LCSW)
Entity type:Individual
Prefix:
First Name:VELISKA
Middle Name:JOY
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 1:744 TELL STREET, STE 100
Mailing Address - Street 2:P.O. BOX 367
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37371-0367
Mailing Address - Country:US
Mailing Address - Phone:423-507-8826
Mailing Address - Fax:
Practice Address - Street 1:744 TELL ST
Practice Address - Street 2:STE 100
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-3148
Practice Address - Country:US
Practice Address - Phone:423-507-8826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN54751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical