Healthcare Provider Details

I. General information

NPI: 1093056400
Provider Name (Legal Business Name): MRS. ALISHA MARIA THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAYANA THOMPSON

II. Dates (important events)

Enumeration Date: 03/11/2013
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 CLINTON AVE APT 2
JERSEY CITY NJ
07304-1608
US

IV. Provider business mailing address

254 CLINTON AVE APT 2
JERSEY CITY NJ
07304-1608
US

V. Phone/Fax

Practice location:
  • Phone: 917-830-5239
  • Fax:
Mailing address:
  • Phone: 917-830-5239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number291636
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number55818
License Number StateSC
# 6
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNJ
# 8
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: