Provider Demographics
NPI:1730726415
Name:CROOK, THOMAS (LSW)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:CROOK
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 N EASTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3210
Mailing Address - Country:US
Mailing Address - Phone:740-205-7843
Mailing Address - Fax:
Practice Address - Street 1:1170 OLD HENDERSON RD STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3623
Practice Address - Country:US
Practice Address - Phone:614-442-7650
Practice Address - Fax:614-442-7656
Is Sole Proprietor?:No
Enumeration Date:2019-12-02
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 104100000X
OHS.23087041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker