Basic Information
| Provider Information | |||||||||
| NPI: | 1912369059 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | MCKENZIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LSW | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | STEP BY STEP ACADEMY | ||||||||
| Address2: | 445 E. DUBLIN GRANVILLE RD. | ||||||||
| City: | WORTHINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430853183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144367837 | ||||||||
| FaxNumber: | 6145455779 | ||||||||
| Practice Location | |||||||||
| Address1: | STEP BY STEP ACADEMY | ||||||||
| Address2: | 445 E. DUBLIN GRANVILLE RD. | ||||||||
| City: | WORTHINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430853183 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144367837 | ||||||||
| FaxNumber: | 6145455779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2016 | ||||||||
| LastUpdateDate: | 06/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | S1501005 | OH | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.