Individual
MRS. TIA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
34 LOUELLA ST, BLACKFOOT, ID 83221-1609
(208) 317-6318
(208) 782-1074
Mailing address
488 W 200 N, BLACKFOOT, ID 83221-5405
(208) 317-6318
(208) 782-1074
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-25452
ID
104100000X
Social Worker
LCSW25452
ID
Other
Enumeration date
09/03/2006
Last updated
08/02/2025
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