Provider Demographics
NPI:1457655417
Name:THOMAS, MINDI BETH (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MINDI
Middle Name:BETH
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 87554
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-7554
Mailing Address - Country:US
Mailing Address - Phone:630-297-5493
Mailing Address - Fax:
Practice Address - Street 1:3255 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 512
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1586
Practice Address - Country:US
Practice Address - Phone:630-297-5493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490062681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical