Provider Demographics
NPI:1639229230
Name:THOMPSON, MICHAEL V (MSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:V
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 GREEN ST
Mailing Address - Street 2:APT 1 RIGHT
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-5553
Mailing Address - Country:US
Mailing Address - Phone:603-557-7826
Mailing Address - Fax:
Practice Address - Street 1:23 GREEN ST
Practice Address - Street 2:APT 1 RIGHT
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-5553
Practice Address - Country:US
Practice Address - Phone:603-557-7826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHMASS PENDING101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor