Provider Demographics
NPI:1013257625
Name:THOMPSON, KAREN A (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:A
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:66 HIRSCH LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-2731
Mailing Address - Country:US
Mailing Address - Phone:718-494-7228
Mailing Address - Fax:718-494-7228
Practice Address - Street 1:66 HIRSCH LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-2731
Practice Address - Country:US
Practice Address - Phone:718-494-7228
Practice Address - Fax:718-494-7228
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0409041104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker