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NPI Code Detail

MEDICARE: MIKAYLA THOMPSON MSW

MEDICARE: MIKAYLA THOMPSON MSW
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1780516195
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIKAYLA THOMPSON MSW
Provider Business Mailing Address
First Line : 113 W KEETOOWAH ST
Second Line :
City : TAHLEQUAH
State : OK
Zip : 74464-3819
Country : US
Telephone Number : 580-399-1817
Fax Number : 580-399-1817
Provider Business Practice Location Address
First Line : 113 W KEETOOWAH ST
Second Line :
City : TAHLEQUAH
State : OK
Zip : 74464-3819
Country : US
Telephone Number : 580-399-1817
Fax Number : 580-399-1817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2026
Last Update Date : 06/01/2026

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Directions to “ MIKAYLA THOMPSON MSW” Practice Location

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