Individual provider Active NPI

Wanda L Thomas, LMSW-CC

  • Clinical Social Worker
  • Westbrook, ME
National Provider Identifier
1023385259
Registry record updated Nov 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MC11865 Issued in ME
Practice address
21 Saco St
Westbrook, ME 04092-2856
Phone
(865) 373-1050
Fax
(207) 591-4159
NPI assigned
Nov 16, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MC11865 ME Primary

Addresses

Primary practice location

21 Saco St
Westbrook, ME 04092-2856

Mailing address

21 Saco St
Westbrook, ME 04092-2856
Phone (865) 373-1050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MC11865MEMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1023385259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SACO ST",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040922856",
            "telephone_number": "865-373-1050",
            "fax_number": "207-591-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SACO ST",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040922856",
            "telephone_number": "865-373-1050",
            "fax_number": "207-591-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "WANDA",
        "middle_name": "L",
        "credential": "LMSW-CC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "MC11865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westbrook, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.