1457796450 NPI number — SUSAN M. THOMPSON-DOERING MSW, LMSW

Table of content: SUSAN M. THOMPSON-DOERING MSW, LMSW (NPI 1457796450)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457796450 NPI number — SUSAN M. THOMPSON-DOERING MSW, LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THOMPSON-DOERING
Provider First Name:
SUSAN
Provider Middle Name:
M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW, LMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
THOMPSON-DOERING
Provider Other First Name:
SUSIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1457796450
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 3049
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANN ARBOR
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48106-3049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-412-6143
Provider Business Mailing Address Fax Number:
734-210-1157

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
46240 SPINNING WHEEL DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANTON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48187
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-412-6143
Provider Business Practice Location Address Fax Number:
734-210-1157
Provider Enumeration Date:
05/03/2013

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:  MI6801095253 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: L2461283 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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