Individual
JACKY T. THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1517 NICHOLASVILLE RD STE 400, SUITE 400, LEXINGTON, KY 40503-1429
(859) 276-5285
(859) 277-3513
Mailing address
1517 NICHOLASVILLE RD STE 400, SUITE 400, LEXINGTON, KY 40503-1429
(859) 276-5285
(859) 277-3513
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
406
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000051966
ANTHEM
KY
Enumeration date
05/20/2007
Last updated
07/08/2007
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