Provider Demographics
NPI:1891977807
Name:THOMAS, MAGGIE Z (LCSW)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:Z
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 1:1483 E ORANGE GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-4725
Mailing Address - Country:US
Mailing Address - Phone:626-376-3790
Mailing Address - Fax:626-379-2990
Practice Address - Street 1:1483 E ORANGE GROVE BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-4725
Practice Address - Country:US
Practice Address - Phone:626-376-3790
Practice Address - Fax:626-379-2990
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS230061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical