Provider Demographics
NPI:1861589590
Name:EFIRD, THOMAS B (MSW, LCSW, LCDC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:B
Last Name:EFIRD
Suffix:
Gender:M
Credentials:MSW, LCSW, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9302 HAZELTON LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4742
Mailing Address - Country:US
Mailing Address - Phone:210-239-9597
Mailing Address - Fax:
Practice Address - Street 1:18911 HARDY OAK BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4967
Practice Address - Country:US
Practice Address - Phone:210-239-9597
Practice Address - Fax:210-866-0202
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX616131041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106214Medicaid