Provider Demographics
NPI:1679451843
Name:THOMAS, TAHEEM WILLIE (LCSWA, MSW)
Entity type:Individual
Prefix:
First Name:TAHEEM
Middle Name:WILLIE
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LCSWA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 POPLARWOOD CT STE 207
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-1040
Mailing Address - Country:US
Mailing Address - Phone:919-872-6447
Mailing Address - Fax:
Practice Address - Street 1:3117 POPLARWOOD CT STE 207
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-1040
Practice Address - Country:US
Practice Address - Phone:919-872-6447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0222981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical