Healthcare Provider Details

I. General information

NPI: 1508772724
Provider Name (Legal Business Name): LINDSAY THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 WALTON ST STE 200
SYRACUSE NY
13202-1373
US

IV. Provider business mailing address

7590 MANOR LN
LIVERPOOL NY
13088-3614
US

V. Phone/Fax

Practice location:
  • Phone: 315-944-0007
  • Fax:
Mailing address:
  • Phone: 315-857-7490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number084664-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: