Provider Demographics
NPI:1609240589
Name:THOMPKINS, MICHELLE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:THOMPKINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18087 PINEHURST ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-2365
Mailing Address - Country:US
Mailing Address - Phone:313-283-4131
Mailing Address - Fax:
Practice Address - Street 1:12750 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1624
Practice Address - Country:US
Practice Address - Phone:248-499-4514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-16
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010687041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical