Provider Demographics
NPI:1265684492
Name:THOMAS, CHRISTOPHER SCOTT (LCSW-C, LICSW)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LCSW-C, LICSW
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 148
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-0148
Mailing Address - Country:US
Mailing Address - Phone:410-615-9717
Mailing Address - Fax:
Practice Address - Street 1:5060 DORSEY HALL DR
Practice Address - Street 2:#204
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7884
Practice Address - Country:US
Practice Address - Phone:410-615-9717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD121841041C0700X
DCLC500778801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical