Provider Demographics
NPI:1689682429
Name:THOMPSON, LORNA H (LICSW)
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:H
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 DAYNA DR
Mailing Address - Street 2:
Mailing Address - City:WEST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02817-2065
Mailing Address - Country:US
Mailing Address - Phone:401-331-1350
Mailing Address - Fax:
Practice Address - Street 1:650 TEN ROD RD UNIT 13
Practice Address - Street 2:C/O FAMILY SERVICE OF RHODE ISLAND
Practice Address - City:N KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852-4237
Practice Address - Country:US
Practice Address - Phone:401-331-1350
Practice Address - Fax:401-277-3366
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW017611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
BLUE SHIELDOther24201-5
RILT29912Medicaid
1021740OtherGROUP #-NHP/BEACON
BLUE CHIPOther410421