Organization
JAYAN THOMAS LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYAN THOMAS (PRESIDENT)
(502) 805-5858
Entity
Organization
Contact information
Practice address
13113 EASTPOINT PARK BLVD STE G, LOUISVILLE, KY 40223-4191
(502) 805-5858
(502) 805-5859
Mailing address
4103 BROWNSBORO GLEN RD, LOUISVILLE, KY 40241-1196
(502) 805-5858
(502) 805-5859
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100187730
—
KY
Enumeration date
11/21/2019
Last updated
11/21/2019
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