Provider Demographics
NPI:1447322565
Name:FLANAGAN, TOM J JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:TOM
Middle Name:J
Last Name:FLANAGAN
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:TOM
Other - Middle Name:J
Other - Last Name:FLANAGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3066 THOMPSON RD
Mailing Address - Street 2:
Mailing Address - City:DE SOTO
Mailing Address - State:MO
Mailing Address - Zip Code:63020-5299
Mailing Address - Country:US
Mailing Address - Phone:913-963-4507
Mailing Address - Fax:
Practice Address - Street 1:3066 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:DE SOTO
Practice Address - State:MO
Practice Address - Zip Code:63020-5299
Practice Address - Country:US
Practice Address - Phone:913-963-4507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0024611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical