Provider Demographics
NPI:1770532475
Name:THOMAS-HARMON, AMY M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:M
Last Name:THOMAS-HARMON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7609 TANGLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-1150
Mailing Address - Country:US
Mailing Address - Phone:804-519-0016
Mailing Address - Fax:
Practice Address - Street 1:6962 FOREST HILL AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-1606
Practice Address - Country:US
Practice Address - Phone:804-519-0016
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040055651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical