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General NPI Number Information
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NPI Number | 1205068574
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Entity Type | Individual
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Provider Name | MARIE A THOMSON LCSWR, ACSW
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Gender | Female
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Dates
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Enumeration Date | 08/19/2009
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Last Update Date | 08/19/2009
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Provider Practice Location Address
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Address Line | 420 E MAIN ST
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City | MIDDLETOWN
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State | NY
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Zip | 10940-2516
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Country | US
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Telephone | 845-342-5300
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Fax | 845-342-5602
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Provider Business Mailing Address
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Address Line | 142 SHAWANGA LODGE RD
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City | BLOOMINGBURG
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State | NY
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Zip | 12721-5143
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Country | US
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Telephone | 845-343-3331
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R018216-1
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License Number State | NY
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