Provider Demographics
NPI:1912945221
Name:THOMAS, BERNICE DELORES (SOCIAL WORKER)
Entity Type:Individual
Prefix:MS
First Name:BERNICE
Middle Name:DELORES
Last Name:THOMAS
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 N 73RD TER
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-2315
Mailing Address - Country:US
Mailing Address - Phone:913-682-2000
Mailing Address - Fax:913-758-4219
Practice Address - Street 1:DD EISENHOWER VETERANS AFFAIRS MEDICAL CENTER
Practice Address - Street 2:4101 S. 4TH ST. TRAFFICWAY
Practice Address - City:LEAVENWORTH
Practice Address - State:KY
Practice Address - Zip Code:66048
Practice Address - Country:US
Practice Address - Phone:913-682-2000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW 5771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical