Provider Demographics
NPI:1639367006
Name:THOMPSON, SCOTT LEROY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:LEROY
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3348 ASCONA CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6190
Mailing Address - Country:US
Mailing Address - Phone:808-780-9117
Mailing Address - Fax:
Practice Address - Street 1:3348 ASCONA CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6190
Practice Address - Country:US
Practice Address - Phone:808-780-9117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5316-C1041C0700X
HI34431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical