Provider Demographics
NPI:1740581164
Name:THOMAS, TASHIMA (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:TASHIMA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10821 RED RUN BLVD
Mailing Address - Street 2:#969
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117
Mailing Address - Country:US
Mailing Address - Phone:443-219-7878
Mailing Address - Fax:
Practice Address - Street 1:5900 YORK RD STE 203
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3040
Practice Address - Country:US
Practice Address - Phone:443-219-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2020-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0753171041C0700X
VA09040085561041C0700X
MD182791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical