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MR. THOMAS GWYNNE WALES MSW LICSW NPI 1245491877


NPI Information

NPI: 1245491877
Provider Name: MR. THOMAS GWYNNE WALES, MSW LICSW
Classification: Social Worker - 1041C0700X
Entity Type: Individual

Specialization: Clinical

PECOS Registration: Yes

Address:
627 SNELLING AVE S
SUITE 200
SAINT PAUL, MN
ZIP 55116
Phone: (651) 699-1062
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MR. Thomas Gwynne Wales, MSW LICSW is a clinical social worker in Saint Paul, MN with 26 years of experience. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. MR. Thomas Gwynne Wales, MSW LICSW NPI is 1245491877. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

627 SNELLING AVE S
SUITE 200
SAINT PAUL, MN
ZIP 55116-590
Phone: (651) 699-1062

The NPI 1245491877 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 6/17/2008 and was last updated on 6/18/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical14061MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1444260100MEDICAIDMINNESOTA
2090H8WAOTHERMINNESOTABLUE CROSS BLUE SHIELD OF MINNESOTA CLINIC ID
3090H8WAOTHERMINNESOTABLUE CROSS BLUE SHIELD OF MINNESOTA PROVIDER ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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