Individual
KELLY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7459 BURLINGTON PIKE, FLORENCE, KY 41042-1553
(859) 331-3292
(859) 578-2864
Mailing address
502 FARRELL DR, COVINGTON, KY 41011-3717
(859) 578-3204
(859) 578-3273
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
254297
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610661458
TAX ID
KY
Enumeration date
10/26/2015
Last updated
09/23/2019
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