Provider Demographics
NPI:1497518310
Name:THOMAS-MCRATH, SHATARA ROCQUECCE (LMSW)
Entity Type:Individual
Prefix:
First Name:SHATARA
Middle Name:ROCQUECCE
Last Name:THOMAS-MCRATH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 CRESTWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2611
Mailing Address - Country:US
Mailing Address - Phone:205-957-5327
Mailing Address - Fax:
Practice Address - Street 1:7901 CRESTWOOD BLVD
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-2611
Practice Address - Country:US
Practice Address - Phone:205-957-5327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5717G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker