Provider Demographics
NPI:1922448844
Name:THOMAS, ASHLEY DOMINQUE (LCSW-S)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:DOMINQUE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 WOODLAND PARK DR APT K203
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3257
Mailing Address - Country:US
Mailing Address - Phone:734-474-0800
Mailing Address - Fax:
Practice Address - Street 1:1615 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-8525
Practice Address - Country:US
Practice Address - Phone:713-236-7195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010935511041C0700X
TX634771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical