Provider Demographics
NPI:1912381872
Name:THOMPSON, CORINNE MICHELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:MICHELLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 HULL ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-4071
Mailing Address - Country:US
Mailing Address - Phone:804-230-0999
Mailing Address - Fax:804-230-0998
Practice Address - Street 1:1011 HULL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-4071
Practice Address - Country:US
Practice Address - Phone:804-230-0999
Practice Address - Fax:804-230-0998
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040089201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical