Provider Demographics
NPI:1952870875
Name:MARICIA THOMPSON LCSW PLLC
Entity Type:Organization
Organization Name:MARICIA THOMPSON LCSW PLLC
Other - Org Name:MARICIA THOMPSON LMSW PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARICIA
Authorized Official - Middle Name:TONI
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:347-247-6631
Mailing Address - Street 1:13855 SPRINGFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2600
Mailing Address - Country:US
Mailing Address - Phone:347-247-6631
Mailing Address - Fax:917-387-8469
Practice Address - Street 1:13855 SPRINGFIELD BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-2600
Practice Address - Country:US
Practice Address - Phone:347-247-6631
Practice Address - Fax:917-387-8469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-20
Last Update Date:2022-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency