Individual provider Active NPI

Deborah Thompson, LCSW

  • Clinical Social Worker
  • Coopersburg, PA
National Provider Identifier
1386005536
Registry record updated Nov 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW016075 Issued in PA
Practice address
404 E. Landis Street
Coopersburg, PA 18036
Phone
(484) 553-4812
NPI assigned
Mar 16, 2016
Last updated
Nov 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CW016075 PA
Clinical Social Worker 1041C0700X CW016075 PA Primary

Addresses

Primary practice location

404 E. Landis Street
Coopersburg, PA 18036

Mailing address

404 E. Landis Street
Coopersburg, PA 18036
Phone (484) 553-4812

Other names 1

  • Deborah Siderias Former name

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
CW016075PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy of Pennsylvania, P.C. Clinical CurrentSince Nov 1, 2022 Accepting new patients
Hearthfire Psychology, PLLC Mental Health CurrentSince Apr 3, 2022 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

961 Marcon Blvd
Ste 300
Allentown, PA 18109
Phone (610) 823-7799

815 Chester Pike
Prospect Park, PA 19076
Phone (610) 586-6262

220 N Park Rd
Bldg 5
Wyomissing, PA 19610
Phone (610) 823-7799

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1458086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1386005536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 E. LANDIS STREET",
            "city": "COOPERSBURG",
            "state": "PA",
            "postal_code": "18036",
            "telephone_number": "484-553-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E. LANDIS STREET",
            "city": "COOPERSBURG",
            "state": "PA",
            "postal_code": "18036",
            "telephone_number": "484-553-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DEBORAH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-16",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "CW016075",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "SIDERIAS",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coopersburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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.