Individual provider Active NPI

Heather A Thompson, LCSW

  • Clinical Social Worker
  • Marcellus, NY
National Provider Identifier
1255584249
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082371-1 Issued in NY
Practice address
2830 Howlett Hill Rd
Marcellus, NY 13108-9706
Phone
(908) 403-9147
NPI assigned
Nov 4, 2008
Last updated
Oct 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 082371-1 NY Primary

Addresses

Primary practice location

2830 Howlett Hill Rd
Marcellus, NY 13108-9706

Mailing address

27 Fennell St Ste B
Suite B # 102
Skaneateles, NY 13152-1195
Phone (908) 403-9147

Other identifiers 1

IdentifierTypeStateIssuer
01649605MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082371NYMDSocial Worker
082371-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1255584249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 FENNELL ST STE B",
            "address_2": "SUITE B # 102",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131521195",
            "telephone_number": "908-403-9147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2830 HOWLETT HILL RD",
            "city": "MARCELLUS",
            "state": "NY",
            "postal_code": "131089706",
            "telephone_number": "908-403-9147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "HEATHER",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082371-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01649605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marcellus, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; 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.