Provider Demographics
NPI:1588271407
Name:THOMAS, ANDREW (LICSW)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 M ST SW # N401
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-4019
Mailing Address - Country:US
Mailing Address - Phone:202-258-1631
Mailing Address - Fax:
Practice Address - Street 1:300 M ST SW # N401
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-4019
Practice Address - Country:US
Practice Address - Phone:202-258-1631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-24
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500809661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical