Provider Demographics
NPI:1720843923
Name:THOMPSON, TAMARA (LCSWA)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 OAK AVE # 118
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-4329
Mailing Address - Country:US
Mailing Address - Phone:757-805-6976
Mailing Address - Fax:
Practice Address - Street 1:1400 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3722
Practice Address - Country:US
Practice Address - Phone:980-859-8114
Practice Address - Fax:800-695-6856
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0185971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical