Provider Demographics
NPI:1184660854
Name:THOMPSON, PATRICIA LUCILLE (MSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LUCILLE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 ALLMONT RD
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2846
Mailing Address - Country:US
Mailing Address - Phone:410-496-1196
Mailing Address - Fax:410-496-1196
Practice Address - Street 1:7411 ALLMONT RD
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2846
Practice Address - Country:US
Practice Address - Phone:410-496-1196
Practice Address - Fax:410-496-1196
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD003031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD271617-000OtherMAGELLAN
MD281689OtherMAMSI
MD777751500Medicaid
5695219OtherAETNA
MD035271OtherJOHNS HOPKINS HEALTHCARE
1001026243OtherAPS HEALTHCARE
MD2679544OtherCIGNA
MD1184660854OtherUNITED HEALTHCARE
DCT541-0045OtherCAREFIRST BCBS