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NPI Code Detail

MEDICARE: KADISHA A THOMPSON LMSW

MEDICARE: KADISHA A 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
1104100000XSocial Worker092494-1NY

General Provider Information

NPI Number : 1790383842
Entity Type Code : Individual
Provider Name (Legal Business Name) : KADISHA A THOMPSON LMSW
Provider Business Mailing Address
First Line : 1333A NORTH AVE STE 209
Second Line :
City : NEW ROCHELLE
State : NY
Zip : 10804-2120
Country : US
Telephone Number : 160-965-1106
Fax Number :
Provider Business Practice Location Address
First Line : 2381 HYLAN BLVD STE 13
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10306-3145
Country : US
Telephone Number : 718-494-2858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2020
Last Update Date : 12/21/2025

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