MEDICARE: CIERA THOMPSON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	65739	TX

General Provider Information

NPI Number	:	1093492365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIERA THOMPSON LCSW

Provider Business Mailing Address
First Line	:	13100 NOEL RD APT 112
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-0100
Country	:	US
Telephone Number	:	254-733-9373
Fax Number	:

Provider Business Practice Location Address
First Line	:	3021 GATEWAY DR STE 295
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-2639
Country	:	US
Telephone Number	:	888-854-1397
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2023
Last Update Date	:	06/29/2023

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