Provider Demographics
NPI:1497015101
Name:SINGLETON, THOMAS WENDELL (LSW)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:WENDELL
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 COLLINGWOOD BLVD
Mailing Address - Street 2:#1007
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-5097
Mailing Address - Country:US
Mailing Address - Phone:313-587-2979
Mailing Address - Fax:
Practice Address - Street 1:2525 W BANCROFT ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43607-1311
Practice Address - Country:US
Practice Address - Phone:419-578-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0500323104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker