Provider Demographics
NPI:1265885362
Name:THOMAS, SHELIA M (MSW, LSW)
Entity type:Individual
Prefix:
First Name:SHELIA
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4260 GLENDALE MILFORD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BLUE ASH
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3752
Mailing Address - Country:US
Mailing Address - Phone:513-745-9993
Mailing Address - Fax:513-745-9993
Practice Address - Street 1:4260 GLENDALE MILFORD RD STE 101
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-3752
Practice Address - Country:US
Practice Address - Phone:513-745-9993
Practice Address - Fax:513-745-9993
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1600456104100000X
OHI.1901453-SUPV104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0261411Medicaid