Individual provider Active NPI

Kellyn Elizabeth Thompson, LCSW

  • Social Worker
  • Somersworth, NH
National Provider Identifier
1285110742
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
63420 Issued in TX
Practice address
5 Terrascape Pkwy
Somersworth, NH 03878-1115
Phone
(915) 630-2268
NPI assigned
Jul 17, 2018
Last updated
Apr 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 63420 TX Primary

Addresses

Primary practice location

5 Terrascape Pkwy
Somersworth, NH 03878-1115

Mailing address

5 Terrascape Pkwy
Somersworth, NH 03878-1115
Phone (915) 630-2268

Other practice location 1

718 Smyth Rd
Manchester, NH 03104-7007
Phone (603) 624-4366

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
63420TXMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1285110742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 TERRASCAPE PKWY",
            "city": "SOMERSWORTH",
            "state": "NH",
            "postal_code": "038781115",
            "telephone_number": "915-630-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 TERRASCAPE PKWY",
            "city": "SOMERSWORTH",
            "state": "NH",
            "postal_code": "038781115",
            "telephone_number": "915-630-2268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "718 Smyth Rd",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031047007",
            "country_code": "US",
            "telephone_number": "603-624-4366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KELLYN",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "63420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somersworth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.