Provider Demographics
NPI:1184397846
Name:LAKEISHA THOMAS PLLC
Entity type:Organization
Organization Name:LAKEISHA THOMAS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKEISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:734-799-6033
Mailing Address - Street 1:813 E MICHIGAN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5801
Mailing Address - Country:US
Mailing Address - Phone:734-799-6033
Mailing Address - Fax:734-800-3208
Practice Address - Street 1:813 E MICHIGAN AVE STE 201
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5801
Practice Address - Country:US
Practice Address - Phone:734-799-6033
Practice Address - Fax:734-800-3208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-28
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty