Provider Demographics
NPI:1437233996
Name:COSS, THOMAS HAROLD (LISW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:HAROLD
Last Name:COSS
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4644 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3805
Mailing Address - Country:US
Mailing Address - Phone:216-291-0570
Mailing Address - Fax:
Practice Address - Street 1:54 S STATE ST
Practice Address - Street 2:SUITE 204
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-3445
Practice Address - Country:US
Practice Address - Phone:440-357-6740
Practice Address - Fax:440-350-0506
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI .00001441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical