Provider Demographics
NPI:1437284668
Name:THOMAS, ADRIANE D (LCSW)
Entity Type:Individual
Prefix:
First Name:ADRIANE
Middle Name:D
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 1:5380 WHITNEY CT
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30088-3249
Mailing Address - Country:US
Mailing Address - Phone:770-879-6975
Mailing Address - Fax:
Practice Address - Street 1:2799 METROPOLITAN PKWY SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-7913
Practice Address - Country:US
Practice Address - Phone:404-762-4111
Practice Address - Fax:404-762-4109
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional