Provider Demographics
NPI:1518543594
Name:THOMAS, LINDA R (MSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:R
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 1:9005 WALKER RD APT 1222
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71118-2483
Mailing Address - Country:US
Mailing Address - Phone:318-332-3970
Mailing Address - Fax:
Practice Address - Street 1:9005 WALKER RD APT 1222
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71118-2483
Practice Address - Country:US
Practice Address - Phone:318-332-3970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator