Provider Demographics
NPI:1891869194
Name:THOMAS, BETH GAIL (LCSW)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:GAIL
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 1:18TH MEDICAL GROUP
Mailing Address - Street 2:
Mailing Address - City:KADENA AFB
Mailing Address - State:OKINAWA
Mailing Address - Zip Code:96368
Mailing Address - Country:JP
Mailing Address - Phone:01181611-734-0433
Mailing Address - Fax:01181611-734-4484
Practice Address - Street 1:18TH MEDICAL GROUP
Practice Address - Street 2:
Practice Address - City:KADENA AFB
Practice Address - State:OKINAWA
Practice Address - Zip Code:96368
Practice Address - Country:JP
Practice Address - Phone:01181611-734-0433
Practice Address - Fax:01181611-734-4484
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW58871041C0700X
OK25711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical