Provider Demographics
NPI:1760638910
Name:THOMAS, RODNEY CARTER (MSW)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:CARTER
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:R CARTER
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW-S
Mailing Address - Street 1:2475 COLLINGWOOD BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43620-1180
Mailing Address - Country:US
Mailing Address - Phone:419-822-7319
Mailing Address - Fax:419-590-0007
Practice Address - Street 1:2475 COLLINGWOOD BLVD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43620-1186
Practice Address - Country:US
Practice Address - Phone:419-822-7319
Practice Address - Fax:419-590-0007
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
OHI.12004851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker