Provider Demographics
NPI:1528434461
Name:THOMAS, JACQUELINE ANN (LICSW)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ANN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HARDING ST
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-1216
Mailing Address - Country:US
Mailing Address - Phone:774-993-9329
Mailing Address - Fax:508-359-1853
Practice Address - Street 1:9 HARDING ST
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-1216
Practice Address - Country:US
Practice Address - Phone:774-993-9329
Practice Address - Fax:508-359-1853
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical