Provider Demographics
NPI:1609933175
Name:THOMPSON, OPAL JEAN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:OPAL
Middle Name:JEAN
Last Name:THOMPSON
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 1:4906 SIGMOND DRIVE
Mailing Address - Street 2:415
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-0727
Mailing Address - Country:US
Mailing Address - Phone:817-483-0194
Mailing Address - Fax:817-483-0194
Practice Address - Street 1:4906 SIGMOND DR
Practice Address - Street 2:415
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-0727
Practice Address - Country:US
Practice Address - Phone:817-483-0194
Practice Address - Fax:817-483-0194
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01732104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker