Provider Demographics
NPI:1407165970
Name:THOMPSON, KESI NOBLES (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KESI
Middle Name:NOBLES
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2595
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28359-2595
Mailing Address - Country:US
Mailing Address - Phone:910-316-5816
Mailing Address - Fax:
Practice Address - Street 1:325 E 4TH ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-5526
Practice Address - Country:US
Practice Address - Phone:910-316-5816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-01
Last Update Date:2010-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0069921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical