Provider Demographics
NPI:1558131516
Name:THOMAS, LAKISHA MICHELLE (LMSW)
Entity Type:Individual
Prefix:
First Name:LAKISHA
Middle Name:MICHELLE
Last Name:THOMAS
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 1:463 FASHION AVE FL 18
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-7760
Mailing Address - Country:US
Mailing Address - Phone:347-260-0072
Mailing Address - Fax:718-710-4070
Practice Address - Street 1:463 FASHION AVE FL 18
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-7760
Practice Address - Country:US
Practice Address - Phone:347-260-0072
Practice Address - Fax:718-710-4070
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-02
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP126440104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker