Provider Demographics
NPI:1891384475
Name:THOMAS, KELI (LMSW)
Entity Type:Individual
Prefix:
First Name:KELI
Middle Name:
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 1:7305 GAMBIER DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4492
Mailing Address - Country:US
Mailing Address - Phone:240-595-0427
Mailing Address - Fax:
Practice Address - Street 1:9701 PHILADELPHIA CT STE M
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4400
Practice Address - Country:US
Practice Address - Phone:301-210-4860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD259341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty