Thomas, Shad M

Thomas, Shad M is an individual health care provider with primary practice located at 2200 4Th St , Baker City OR 97814-2615. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Thomas, Shad M can be contacted via phone (541) 573-7303.

Contact Information

Primary practice address
2200 4Th St Baker City OR 97814-2615
Phone: (541) 573-7303
Fax: (541) 573-5938
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 16-01-16 Oregon
Behavioral Health & Social Service Providers / Clinical 1041C0700X L6915 Oregon

Profile Details

NPI number 1013287507
LBN Legal business name Thomas, Shad M
Credentials LCSW, MSW, CADC III
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 30th, 2011
Last updated Apr 3rd, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013287507 NPPES
Oregon MEDICAID 090450
Oregon Other 500666423

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