Healthcare Provider Details

I. General information

NPI: 1831185958
Provider Name (Legal Business Name): DEBORAH JEAN THOMPSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 N MAIN ST
THREE RIVERS MI
49093-2336
US

IV. Provider business mailing address

53966 WILBUR RD
THREE RIVERS MI
49093-9765
US

V. Phone/Fax

Practice location:
  • Phone: 269-718-8525
  • Fax:
Mailing address:
  • Phone: 269-718-8525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801090880
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: