Individual provider Active NPI

Monica Lori Thompson, LMSW, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1386187797
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
084982 Issued in NY
Practice address
100 Billingsley Rd
Charlotte, NC 28211-1002
Phone
(704) 376-7447
NPI assigned
Dec 2, 2016
Last updated
Oct 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 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 090411 NY
Clinical Social Worker 1041C0700X 084982 NY Primary

Addresses

Primary practice location

100 Billingsley Rd
Charlotte, NC 28211-1002

Mailing address

203 W 117TH St
3E
New York, NY 10026-2108
Phone (917) 543-8684

Other practice location 1

203 W 117th St
3E
New York, NY 10026-2108
Phone (917) 543-8684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20241112000456 NC Practitioner - Clinical Social Worker 0840692372

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
090411NYMDSocial Worker
084982NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicians of the Diaspora, LLC CurrentSince Nov 8, 2020 Accepting new patients

Organizations & group practices 1

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": "1480636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1386187797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W 117TH ST",
            "address_2": "3E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100262108",
            "telephone_number": "917-543-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BILLINGSLEY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111002",
            "telephone_number": "704-376-7447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "203 W 117th St",
            "address_2": "3E",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100262108",
            "country_code": "US",
            "telephone_number": "917-543-8684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MONICA",
        "middle_name": "LORI",
        "name_prefix": "Ms.",
        "credential": "LMSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-02",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "090411",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.