Provider Demographics
NPI:1275889990
Name:THOMAS, JESSICA SALINIS (LCSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SALINIS
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 POMONA DR STE A
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1644
Mailing Address - Country:US
Mailing Address - Phone:336-542-3190
Mailing Address - Fax:336-855-0466
Practice Address - Street 1:1208 EASTCHESTER DR STE 107
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3066
Practice Address - Country:US
Practice Address - Phone:336-802-2900
Practice Address - Fax:336-802-2901
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0079821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical