Individual provider Active NPI

Mary R. Thompson, LMSW

  • Clinical Social Worker
  • Sandusky, MI
National Provider Identifier
1609945062
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801059681 Issued in MI
Practice address
217 E. Sanilac
Suite One
Sandusky, MI 48471
Phone
(810) 648-4450
Fax
(810) 648-5833
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6801059681 MI Primary

Addresses

Primary practice location

217 E. Sanilac
Suite One
Sandusky, MI 48471

Mailing address

6216 Kilgour St
Marlette, MI 48453-1363
Phone (989) 635-2168

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
6801059681MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sanilac County Community Mental Health Authority PastSince Sep 6, 2005 Accepting new patients
Sanilac County Community Mental Health Past Accepting new patients

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609945062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6216 KILGOUR ST",
            "city": "MARLETTE",
            "state": "MI",
            "postal_code": "484531363",
            "telephone_number": "989-635-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E. SANILAC",
            "address_2": "SUITE ONE",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "48471",
            "telephone_number": "810-648-4450",
            "fax_number": "810-648-5833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MARY",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801059681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.