Thomas A. Addis

Individual provider Active NPI Clinical Social Worker · Monroe, NC

NPI 1477848265 · NPPES record last updated Jul 30, 2014

Key facts

NPI
1477848265
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
C009001 (NC)
Practice address
1190 W. Roosevelt Blvd
Monroe, NC 28110-2818
Phone
(704) 296-6200
NPI assigned
Jun 9, 2011
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
C009001NCMDClinical Social Worker
P007343NCMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P007343 NC
Clinical Social Worker 1041C0700X C009001 NC Yes

Addresses

Primary practice location

1190 W. Roosevelt Blvd
Monroe, NC 28110-2818

Mailing address

284 Executive Park Dr
Ste 100
Concord, NC 28025-1894
Phone (704) 939-1100

Other providers in Monroe, NC

All providers in Monroe, NC · Clinical Social Worker in North Carolina

Sources for this page

Verify at the official NPI Registry.