Provider Demographics
NPI:1447793310
Name:AWAD, THASIA N (LSW)
Entity Type:Individual
Prefix:
First Name:THASIA
Middle Name:N
Last Name:AWAD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2214 TEDROW RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3859
Mailing Address - Country:US
Mailing Address - Phone:419-725-1415
Mailing Address - Fax:419-389-6284
Practice Address - Street 1:117 MAIN STREET
Practice Address - Street 2:SUITE B
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43605-2209
Practice Address - Country:US
Practice Address - Phone:419-725-1415
Practice Address - Fax:419-389-6284
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.10003791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical