Provider Demographics
NPI:1912519950
Name:THOMPSON, LIONEL JR
Entity Type:Individual
Prefix:
First Name:LIONEL
Middle Name:
Last Name:THOMPSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BELLEVUE HOSPITAL CENTER CHILD & ADOLESCENT PSYCHIATRY
Mailing Address - Street 2:462 FIRST AVENUE ADMINISTRATION BLDG. 2ND FL.
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027
Mailing Address - Country:US
Mailing Address - Phone:212-562-4991
Mailing Address - Fax:212-562-8653
Practice Address - Street 1:BELLEVUE HOSPITAL CENTER CHILD & ADOLESCENT PSYCHIATRY
Practice Address - Street 2:462 FIRST AVENUE ADMINISTRATION BLDG. 2ND FL.
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-562-4991
Practice Address - Fax:212-562-8653
Is Sole Proprietor?:No
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071457-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical