Blake Reagan Thomas, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2006032914 Issued in MO

Practice address

2005 Robin Ter
Columbia, MO 65203-1543

Phone

(573) 864-1533

NPI assigned

Jan 7, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Blake Thomas Witter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1790960045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 ROBIN TER",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652031543",
            "telephone_number": "847-970-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 ROBIN TER",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652031543",
            "telephone_number": "573-864-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "BLAKE",
        "middle_name": "REAGAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2006032914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLAKE",
            "last_name": "WITTER",
            "middle_name": "THOMAS",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Courtney Elizabeth Thies, PA-C
• Karen Marie Thies, DO
• Nanda Deepa Thimmappa, M.D.
• Thomas a. Elliott, D.D.S.
• Ashley Lynne Thomas, FNP-C
• David Thomas, FNP
• David R Thomas, LCSW
• Ellen H Thomas, MD.
• Jonathan L Thomas, M.D.
• Kevin George Thomas, DDS

• Clinical Social Worker in Columbia, MO
• Providers in Columbia, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.