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General NPI Number Information
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NPI Number | 1245532209
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Entity Type | Organization
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Legal Business Name | THOMPSON CLINICAL PRACTICE, LLC
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Dates
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Enumeration Date | 11/24/2010
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 2716 OLD ROSEBUD RD SUITE 210
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City | LEXINGTON
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State | KY
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Zip | 40509-8008
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Country | US
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Telephone | 859-963-9010
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Fax | 859-963-9055
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Provider Business Mailing Address
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Address Line | 2716 OLD ROSEBUD RD SUITE 210
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City | LEXINGTON
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State | KY
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Zip | 40509-8008
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Country | US
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Telephone | 859-963-9010
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Fax | 859-963-9055
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | RHONDA KAYE DANIEL
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Credential | LCSW
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Telephone | 859-963-9010
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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 | 1670
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License Number State | KY
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