MEDICARE: KEONA THOMPSON LMSW

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
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1770010381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEONA THOMPSON LMSW

Provider Business Mailing Address
First Line	:	42547 CEDAR PARK AVE
Second Line	:
City	:	GONZALES
State	:	LA
Zip	:	70737-7165
Country	:	US
Telephone Number	:	225-717-9540
Fax Number	:

Provider Business Practice Location Address
First Line	:	42547 CEDAR PARK AVE
Second Line	:
City	:	GONZALES
State	:	LA
Zip	:	70737-7165
Country	:	US
Telephone Number	:	225-717-9540
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2017
Last Update Date	:	04/19/2026

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Directions to “ KEONA THOMPSON LMSW” Practice Location

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