Provider Demographics
NPI:1114123155
Name:FLOYD, THOMAS LAWRENCE (ACSW, LCSW-C, LICSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:LAWRENCE
Last Name:FLOYD
Suffix:
Gender:M
Credentials:ACSW, LCSW-C, LICSW
Other - Prefix:MR
Other - First Name:THOMAS
Other - Middle Name:L
Other - Last Name:FLOYD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ACSW, LCSW-C, LICSW
Mailing Address - Street 1:1845 FOGGY BOTTOM COURT
Mailing Address - Street 2:
Mailing Address - City:SUNDERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20689-3008
Mailing Address - Country:US
Mailing Address - Phone:301-655-0842
Mailing Address - Fax:
Practice Address - Street 1:1845 FOGGY BOTTOM COURT
Practice Address - Street 2:
Practice Address - City:SUNDERLAND
Practice Address - State:MD
Practice Address - Zip Code:20689-3008
Practice Address - Country:US
Practice Address - Phone:301-655-0842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD146171041C0700X
DCLC3013001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCLC301300OtherCOMMERCIAL INSURANCE
MD14617OtherCOMMERCIAL INSURANCES