Healthcare Provider Details

I. General information

NPI: 1144007352
Provider Name (Legal Business Name): ALEXANDRA L THOMPSON-NORMAN DBH, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3181 POPLAR AVE
MEMPHIS TN
38111-3542
US

IV. Provider business mailing address

1150 RESERVOIR AVE STE 203
CRANSTON RI
02920-6032
US

V. Phone/Fax

Practice location:
  • Phone: 901-504-5301
  • Fax:
Mailing address:
  • Phone: 401-259-0340
  • Fax: 401-213-8538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9864
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: