Provider Demographics
NPI:1164454898
Name:THOMAS, AMY (LISW, LCSW)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LISW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 HOUSTON RD
Mailing Address - Street 2:SUITE 29
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-4873
Mailing Address - Country:US
Mailing Address - Phone:859-746-9272
Mailing Address - Fax:
Practice Address - Street 1:800 COMPTON RD UNIT 12
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-3846
Practice Address - Country:US
Practice Address - Phone:859-746-9272
Practice Address - Fax:513-521-3175
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY184607OtherMEDICARE GROUP NUMBER
KY610661458OtherFEDERAL TAX ID NUMBER