Provider Demographics
NPI:1598905697
Name:THOMPSON, SHERI L (LCSW)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:L
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 CRESTMONT RD
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-5811
Mailing Address - Country:US
Mailing Address - Phone:207-735-5150
Mailing Address - Fax:
Practice Address - Street 1:88 HAMMOND ST
Practice Address - Street 2:STE 402
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4953
Practice Address - Country:US
Practice Address - Phone:207-631-4056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC128211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical