Provider Demographics
NPI:1972716900
Name:THOMAS, PAMELA LOUISE (LCSW)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:LOUISE
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:PO BOX 1450
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11202-1450
Mailing Address - Country:US
Mailing Address - Phone:718-783-0692
Mailing Address - Fax:718-783-0692
Practice Address - Street 1:21 SAINT JAMES PL APT 3N
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-5023
Practice Address - Country:US
Practice Address - Phone:917-279-6197
Practice Address - Fax:718-783-0692
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2009-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0375511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical