Provider Demographics
NPI:1386232759
Name:THOMAS, LAKEISHA D (LLMSW)
Entity Type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:D
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 E MICHIGAN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5801
Mailing Address - Country:US
Mailing Address - Phone:734-799-6033
Mailing Address - Fax:
Practice Address - Street 1:26471 W HILLS DR
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-1983
Practice Address - Country:US
Practice Address - Phone:734-772-4903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-01
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011051801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical