Provider Demographics
NPI:1184595597
Name:THOMAS, JAQUASHIA (MSW)
Entity type:Individual
Prefix:
First Name:JAQUASHIA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 EASY ST
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-4302
Mailing Address - Country:US
Mailing Address - Phone:321-408-3348
Mailing Address - Fax:
Practice Address - Street 1:435 EASY ST
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4302
Practice Address - Country:US
Practice Address - Phone:321-408-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator