Provider Demographics
NPI:1427226596
Name:THOMPSON-KASSELS, NANCY ALICE (LICSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ALICE
Last Name:THOMPSON-KASSELS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 180418
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-0005
Mailing Address - Country:US
Mailing Address - Phone:413-530-7102
Mailing Address - Fax:
Practice Address - Street 1:264 BEACON ST FL 5
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-1236
Practice Address - Country:US
Practice Address - Phone:413-530-7102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1112601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical