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NPI Code Detail

MEDICARE: MR. ROBERT ALLEN THOMPSON LCSW/ APRN

MEDICARE: MR. ROBERT ALLEN THOMPSON LCSW/ APRN
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
11041C0700XClinical Social WorkerKY1390KY
2363LP0808XPsychiatric/Mental Health Nurse Practitioner4057134KY

General Provider Information

NPI Number : 1588658603
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT ALLEN THOMPSON LCSW/ APRN
Provider Business Mailing Address
First Line : 115 ROCKWOOD LN
Second Line :
City : HAZARD
State : KY
Zip : 41701-9415
Country : US
Telephone Number : 606-436-5761
Fax Number : 606-436-5797
Provider Business Practice Location Address
First Line : 115 ROCKWOOD LN
Second Line :
City : HAZARD
State : KY
Zip : 41701-9415
Country : US
Telephone Number : 606-436-5761
Fax Number : 606-436-5797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 05/20/2026

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