Provider Demographics
NPI:1649781451
Name:THOMAS, EBONI DEANNA (MSW)
Entity type:Individual
Prefix:MRS
First Name:EBONI
Middle Name:DEANNA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:EBONI
Other - Middle Name:DEANNA
Other - Last Name:LANKARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:1640 PLUM ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-3463
Mailing Address - Country:US
Mailing Address - Phone:630-966-4475
Mailing Address - Fax:630-892-0027
Practice Address - Street 1:525 N EDGELAWN DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-4327
Practice Address - Country:US
Practice Address - Phone:630-966-4211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health