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NPI Code Detail

MEDICARE: DE'ASIA L. THOMPSON, LISW, LLC

MEDICARE: DE'ASIA L. THOMPSON, LISW, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist
2101YP2500XProfessional Counselor
31041C0700XClinical Social Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356857403
Entity Type Code : Organization
Provider Name (Legal Business Name) : DE'ASIA L. THOMPSON, LISW, LLC
Provider Business Mailing Address
First Line : 7031 CORPORATE WAY STE 103
Second Line :
City : DAYTON
State : OH
Zip : 45459-4262
Country : US
Telephone Number : 937-619-9089
Fax Number : 937-265-6028
Provider Business Practice Location Address
First Line : 7031 CORPORATE WAY STE 103
Second Line :
City : DAYTON
State : OH
Zip : 45459-4262
Country : US
Telephone Number : 937-619-9089
Fax Number : 937-265-6028
Authorized Official
Title or Position : FOUNDER
Name : DE'ASIA LANEE THOMPSON
Credential : LISW-S
Telephone Number : 937-619-9089
Provider Enumeration Date : 12/26/2017
Last Update Date : 06/11/2024

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Directions to “DE'ASIA L. THOMPSON, LISW, LLC ” Practice Location

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