Provider Demographics
NPI:1992313266
Name:THOMASON, PAULA NICOLE (LICSW)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:NICOLE
Last Name:THOMASON
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 1:4407 2ND ST NE APT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5142
Mailing Address - Country:US
Mailing Address - Phone:415-410-8815
Mailing Address - Fax:
Practice Address - Street 1:4407 2ND ST NE APT 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5142
Practice Address - Country:US
Practice Address - Phone:415-410-8815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-22
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500824191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical