Provider Demographics
NPI:1306855945
Name:THOMPSON, LOIS JD (CMSW)
Entity Type:Individual
Prefix:MS
First Name:LOIS
Middle Name:JD
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 RESIDENZ PKWY APT C
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-6296
Mailing Address - Country:US
Mailing Address - Phone:937-396-1186
Mailing Address - Fax:
Practice Address - Street 1:4100 W EST 3RD ST. U.S. DEPARTMENT OF VETERANS AFFAIRS
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45428-9000
Practice Address - Country:US
Practice Address - Phone:937-268-6511
Practice Address - Fax:937-267-5314
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCSW0000006469104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker