| Mr Douglas Paul Thomas, LCSW | |
| 
					100 S 1000 W, Tooele, UT 84074-4010  | |
| (435) 843-3520 | |
| (435) 843-3555 | 
| Full Name | Mr Douglas Paul Thomas | 
|---|---|
| Gender | Male | 
| Speciality | Social Worker - Clinical | 
| Location | 100 S 1000 W, Tooele, Utah | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1356327084 | NPI | - | NPPES | 
| 751648 | Other | DESERET MUTUAL | |
| 94293848015 | Other | CHAMPUS | |
| 107012410101 | Other | INTERMOUNTAIN HEALTH CARE | |
| 29297535000001 | Other | BLUE CROSS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 292975-3501 (Utah) | Primary | 
| Entity Name | Sundance Behavioral Resources Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1326157355 PECOS PAC ID: 5496979239 Enrollment ID: O20140617001287  | 
| Entity Name | Optum Behavioral Care Of Ohio Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1942076633 PECOS PAC ID: 7719325083 Enrollment ID: O20240723004739  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mr Douglas Paul Thomas, LCSW 100 S 1000 W, Tooele, UT 84074-4010 Ph: () -  | Mr Douglas Paul Thomas, LCSW 100 S 1000 W, Tooele, UT 84074-4010 Ph: (435) 843-3520  | 
Keri B Stone,  Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 71 N 50 W, Tooele, UT 84074 Phone: 801-990-4300 Fax: 801-967-2127  | |
Reina Marie Hansen,  Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1244 N Main St Ste 203, Tooele, UT 84074 Phone: 435-882-4354  | |
Mr. Chris Corey Hakes, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 50 N Main St, Tooele, UT 84074 Phone: 801-414-3252 Fax: 801-967-2127  | |
Pamela Joan Bennett, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 100 S 1000 W, Tooele, UT 84074 Phone: 435-843-3520  | |
Jennifer Westover,  Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 22 W Vine St, Tooele, UT 84074 Phone: 435-882-4354  | |
Hayley Baldwin Baldwin, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2356 N 400 E, Tooele, UT 84074 Phone: 435-850-2547  | |
Ms. Sarah Louise Debois, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 100 S 1000 W, Tooele, UT 84074 Phone: 435-843-3520 Fax: 435-843-3555  |