1689682429 NPI number — LORNA H. THOMPSON LICSW

Table of content: LORNA H. THOMPSON LICSW (NPI 1689682429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689682429 NPI number — LORNA H. THOMPSON LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THOMPSON
Provider First Name:
LORNA
Provider Middle Name:
H.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689682429
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
71 DAYNA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST GREENWICH
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02817-2065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-331-1350
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
650 TEN ROD RD UNIT 13
Provider Second Line Business Practice Location Address:
C/O FAMILY SERVICE OF RHODE ISLAND
Provider Business Practice Location Address City Name:
N KINGSTOWN
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02852-4237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-331-1350
Provider Business Practice Location Address Fax Number:
401-277-3366
Provider Enumeration Date:
08/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  ISW01761 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: BLUE SHIELD . This is a "24201-5" identifier . This identifiers is of the category "OTHER".
  • Identifier: LT29912 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1021740 . This is a "GROUP #-NHP/BEACON" identifier . This identifiers is of the category "OTHER".
  • Identifier: BLUE CHIP . This is a "410421" identifier . This identifiers is of the category "OTHER".




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