1548349822 NPI number — DR. PATRICIA NOWICKI THOMPSON PHD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548349822 NPI number — DR. PATRICIA NOWICKI THOMPSON PHD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

THOMPSON

Provider First Name:

PATRICIA

Provider Middle Name:

NOWICKI

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

PHD

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

NOWICKI

Provider Other First Name:

PATRICIA

Provider Other Middle Name:

ANN

Provider Other Name Prefix Text:

DR.

Provider Other Name Suffix Text:

Provider Other Credential Text:

PHD

Provider Other Last Name Type Code:

1

NPI Number:

1548349822

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

02/04/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

3723 BIRCHMERE CT

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

OWINGS MILLS

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

21117-1298

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

443-286-1107

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

1645 LIBERTY ROAD

Provider Second Line Business Practice Location Address:

SUITE 104

Provider Business Practice Location Address City Name:

ELDERSBURG

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

21784

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

410-795-4764

Provider Business Practice Location Address Fax Number:

410-795-4462

Provider Enumeration Date:

11/06/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 103T00000X , with the licence number:  002867 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 322069 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
• Identifier: 002756 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
• Identifier: 322069 . This is a "HEALTHNET TRICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 0005982220 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 136507 . This is a "COMPSYCH" identifier . This identifiers is of the category "OTHER".
• Identifier: 055107000 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 214467 . This is a "UNITED BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 100026127 . This is a "AMERICAN PSYCH SYSTEMS AP" identifier . This identifiers is of the category "OTHER".
• Identifier: 22975 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
• Identifier: 353464 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
• Identifier: 52656001 . This is a "CAREFIRST BLUE CROSS BLUE" identifier . This identifiers is of the category "OTHER".
• Identifier: GK03 . This is a "CAREFIRST BLUE CROSS BLUE" identifier . This identifiers is of the category "OTHER".
• Identifier: R4390001 . This is a "CAREFIRST BLUE CROSS BLUE" identifier . This identifiers is of the category "OTHER".