Doctor Name: | THOMAS JAY MOCK |
NPI Number: | 1225347511 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | C006319 |
Business Practice Address: | 30 Dalya Rd Swannanoa, NC - 287783622 |
Business Phone Number: | 8285054118 |
Business Fax Number: | |
Mailing Address: | 30 Dalya Rd, SWANNANOA |
State: | NC |
Postal Code: | 287783622 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/04/2010 |
NPI Last Update Date: | 10/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | C006319 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |