Provider Demographics
NPI:1801840590
Name:THOMAS, GAIL M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:GAIL
Other - Middle Name:M
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3031 SUMAC CT
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30906-2943
Mailing Address - Country:US
Mailing Address - Phone:706-790-6998
Mailing Address - Fax:
Practice Address - Street 1:1 FREEDOM WAY
Practice Address - Street 2:VA MEDICAL CENTER (AUGUSTA)
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6258
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-823-3952
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0002541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical