Healthcare Provider Details

I. General information

NPI: 1669696787
Provider Name (Legal Business Name): NATHAN H THOMPSON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2950 TENNYSON ST
DENVER CO
80212-3029
US

IV. Provider business mailing address

2950 TENNYSON ST
DENVER CO
80212-3029
US

V. Phone/Fax

Practice location:
  • Phone: 303-433-2541
  • Fax: 303-433-9701
Mailing address:
  • Phone: 303-433-2541
  • Fax: 303-433-9701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number992490
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: