Individual provider Active NPI

Shequita Deche Thompson, LICSW

  • Clinical Social Worker
  • Tuscaloosa, AL
National Provider Identifier
1316660327
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5605C Issued in AL
Practice address
2731 Martin Luther King Blvd
Tuscaloosa, AL 35401-5235
Phone
(205) 349-3250
NPI assigned
Sep 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 5424G AL
Clinical Social Worker 1041C0700X 5605C AL Primary

Addresses

Primary practice location

2731 Martin Luther King Blvd
Tuscaloosa, AL 35401-5235

Mailing address

2731 Martin Luther King, Jr. Blvd.
Tuscaloosa, AL 35401-5235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240307000262 AL Practitioner - Clinical Social Worker 2961848494 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whatley Health Services IncGroup PAC ID 8224921705, 84 clinicians

Practice addresses (Care Compare)

2731 ML King Jr Blvd
Tuscaloosa, AL 35401-5235
Phone (205) 758-6647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5424GALMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Whatley Health Services, Inc. CurrentSince Jan 31, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince Jun 1, 2025 Accepting new patients
Whatley Health Services Inc CurrentSince Jan 31, 2024 Accepting new patients
Whatley Health Services, Inc. Past Accepting new patients
It's Your Move PastSince Sep 1, 2022 Accepting new patients

Locations

200 Morrow Ave
Eutaw, AL 35462
Phone (205) 372-0011

800 Hall St
Greensboro, AL 36744
Phone (334) 624-0871

2731 Ml King Jr Blvd
Tuscaloosa, AL 35401
Phone (205) 349-3250

230 Hospital Dr
Vernon, AL 35592
Phone (205) 614-6060

415 Derby Dr
York, AL 36925
Phone (205) 392-9656

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1316660327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2731 MARTIN LUTHER KING, JR. BLVD.",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354015235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2731 MARTIN LUTHER KING BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354015235",
            "telephone_number": "205-349-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SHEQUITA",
        "middle_name": "DECHE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2024-03-18",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AL",
            "license": "5424G",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "5605C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.