Provider Demographics
NPI:1871645788
Name:THOMAS, DELORES (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DELORES
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 HARDY CASH DR
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-2414
Mailing Address - Country:US
Mailing Address - Phone:757-595-2727
Mailing Address - Fax:757-595-2776
Practice Address - Street 1:1613 HARDY CASH DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2414
Practice Address - Country:US
Practice Address - Phone:757-595-2727
Practice Address - Fax:757-595-2776
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040051251041C0700X, 320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness