Provider Demographics
NPI:1134236730
Name:THOMSON, MARGARET (LCSW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:THOMSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:A
Other - Last Name:THOMSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:3451 BONITA BAY BLVD
Mailing Address - Street 2:SUITE #209
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-4354
Mailing Address - Country:US
Mailing Address - Phone:239-949-3199
Mailing Address - Fax:239-949-7054
Practice Address - Street 1:3451 BONITA BAY BLVD
Practice Address - Street 2:SUITE #209
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-4354
Practice Address - Country:US
Practice Address - Phone:239-949-3199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW52251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ9006Medicare PIN