Provider Demographics
NPI:1912369059
Name:THOMAS, MCKENZIE (LSW)
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:STEP BY STEP ACADEMY
Mailing Address - Street 2:445 E. DUBLIN GRANVILLE RD.
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3183
Mailing Address - Country:US
Mailing Address - Phone:614-436-7837
Mailing Address - Fax:614-545-5779
Practice Address - Street 1:STEP BY STEP ACADEMY
Practice Address - Street 2:445 E. DUBLIN GRANVILLE RD.
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3183
Practice Address - Country:US
Practice Address - Phone:614-436-7837
Practice Address - Fax:614-545-5779
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS15010051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical