A Different Journey, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R059610-1 Issued in NY

Legal business name

A DIFFERENT JOURNEY, LLC

Practice address

26 Court St Ste 1502
Brooklyn, NY 11242-1115

Phone

(646) 263-6227

NPI assigned

Apr 26, 2015

Last updated

Apr 26, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Vivian Stanford Thompson, LCSWRNPI 1629280136

Title

Primary Therapist-Owner

Phone

(646) 263-6227

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vivian Stanford Thompson, LCSWR

  • Clinical Social Worker
  • Brooklyn Ny, NY
  • NPI 1629280136
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430006400000",
    "number": "1235526443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 MAIN AVE",
            "city": "LAKE GROVE",
            "state": "NY",
            "postal_code": "117552000",
            "telephone_number": "646-263-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 COURT ST STE 1502",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112421115",
            "telephone_number": "646-263-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A DIFFERENT JOURNEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-26",
        "last_updated": "2015-04-26",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_middle_name": "STANFORD",
        "authorized_official_title_or_position": "PRIMARY THERAPIST-OWNER",
        "authorized_official_telephone_number": "646-263-6227",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSWR"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R059610-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.