Healthcare Provider Details

I. General information

NPI: 1487024063
Provider Name (Legal Business Name): TAMARA ELAINE JONES-THOMPSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 06/28/2024
Certification Date: 06/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 STUBBS AVE
MONROE LA
71201-5622
US

IV. Provider business mailing address

114 N INGLEWOOD DR
MONROE LA
71203-3933
US

V. Phone/Fax

Practice location:
  • Phone: 318-325-8748
  • Fax: 318-325-8749
Mailing address:
  • Phone: 318-547-0887
  • Fax: 318-325-8749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number4804
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4804
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: