Healthcare Provider Details

I. General information

NPI: 1013500412
Provider Name (Legal Business Name): NY'L THOMPSON LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2021
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 CONNECTICUT AVE NW STE 450
WASHINGTON DC
20036-4359
US

IV. Provider business mailing address

8101 SANDY SPRING RD STE 300 PMB 1028
LAUREL MD
20707
US

V. Phone/Fax

Practice location:
  • Phone: 202-706-7603
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number111700
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25803
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: