MEDICARE: MRS. ERICA T THOMPSON LISW

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	1041C0700X	Clinical Social Worker	I.2406175	OH

General Provider Information

NPI Number	:	1770394553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERICA T THOMPSON LISW

Provider Business Mailing Address
First Line	:	11255 LINCOLNSHIRE DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-2902
Country	:	US
Telephone Number	:	513-675-2548
Fax Number	:

Provider Business Practice Location Address
First Line	:	11255 LINCOLNSHIRE DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45240-2902
Country	:	US
Telephone Number	:	513-675-2548
Fax Number	:

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

Provider Enumeration Date	:	01/20/2025
Last Update Date	:	02/02/2025

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