Healthcare Provider Details

I. General information

NPI: 1841133451
Provider Name (Legal Business Name): ANDREA NICOLE THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 SEMINOLE RD STE 200B
NORTON SHORES MI
49444-3747
US

IV. Provider business mailing address

528 CRESTON ST
MUSKEGON MI
49442-2223
US

V. Phone/Fax

Practice location:
  • Phone: 231-777-2222
  • Fax:
Mailing address:
  • Phone: 231-777-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: