Provider Demographics
NPI:1114475316
Name:THOMAS, SHAWNISHA (MS)
Entity Type:Individual
Prefix:MS
First Name:SHAWNISHA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 PRESTON LN
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:DE
Mailing Address - Zip Code:19938-3306
Mailing Address - Country:US
Mailing Address - Phone:302-336-8028
Mailing Address - Fax:
Practice Address - Street 1:231 N MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1113
Practice Address - Country:US
Practice Address - Phone:302-336-8028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-15
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health