Provider Demographics
NPI:1457470163
Name:THOMAS, SANDY ARLENE (LSW)
Entity Type:Individual
Prefix:MS
First Name:SANDY
Middle Name:ARLENE
Last Name:THOMAS
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 1:67 LAUREL DR
Mailing Address - Street 2:APT. 67U
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-2223
Mailing Address - Country:US
Mailing Address - Phone:570-877-4659
Mailing Address - Fax:
Practice Address - Street 1:650 BOULEVARD AVE
Practice Address - Street 2:
Practice Address - City:DICKSON CITY
Practice Address - State:PA
Practice Address - Zip Code:18519-1710
Practice Address - Country:US
Practice Address - Phone:570-383-2799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW125656104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker