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General NPI Number Information
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NPI Number | 1770959736
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Entity Type | Individual
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Provider Name | CHASITY THOMPSON LCSW-BACS
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Gender | Female
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Dates
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Enumeration Date | 08/13/2015
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 306 JEFFERSON ST
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City | NATCHEZ
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State | MS
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Zip | 39120-3233
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Country | US
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Telephone | 318-403-0501
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Fax |
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Provider Business Mailing Address
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Address Line | 304 N SPRUCE ST
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City | VIDALIA
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State | LA
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Zip | 71373-2738
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Country | US
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Telephone | 318-403-0501
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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 | 10097
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C9488
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License Number State | MS
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