Provider Demographics
NPI:1508639949
Name:THOMAS, MARILU JAMES (MSW)
Entity Type:Individual
Prefix:
First Name:MARILU
Middle Name:JAMES
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 1ST ST N
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-5004
Mailing Address - Country:US
Mailing Address - Phone:434-327-2464
Mailing Address - Fax:
Practice Address - Street 1:361 1ST ST N
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5004
Practice Address - Country:US
Practice Address - Phone:434-327-2464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09030019921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical