Individual provider Active NPI

Marcia A. Todd Thompson, LCSW

  • Clinical Social Worker
  • Gastonia, NC
National Provider Identifier
1619920055
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004111 Issued in NC
Practice address
1106 Scotch Dr
Gastonia, NC 28054-1523
Phone
(704) 674-6284
Fax
(980) 320-0301
NPI assigned
May 18, 2006
Last updated
Apr 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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 C004111 NC Primary

Addresses

Primary practice location

1106 Scotch Dr
Gastonia, NC 28054-1523

Mailing address

1106 Scotch Dr
Gastonia, NC 28054-1523
Phone (704) 674-6284

Other identifiers 2

IdentifierTypeStateIssuer
6003070MedicaidNC
2853544OtherNCMEDICARE PTAN

Other names 1

  • Marcia Alison Thompson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100518000419 NC Practitioner - Clinical Social Worker 2365571056 Reassigns benefits to 2 organizations
Practice locations: Gastonia, NC
I20220929003935 VA Practitioner - Clinical Social Worker 2365571056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brinkley Brown Mental Wellness PLLCGroup PAC ID 3173917010, 10 clinicians

Practice addresses (Care Compare)

1480 Chapel Ridge Rd
Suite 220
Apex, NC 27502-8504
Phone (919) 355-9792

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C004111NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Project 1, Inc Clinical CurrentSince Feb 18, 2018 Accepting new patients
Genesis Project Medical Laboratory CurrentSince Feb 18, 2018 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Sep 19, 2022 Accepting new patients
Brinkley Brown Mental Wellness PLLC Clinical CurrentSince May 23, 2024 Accepting new patients
Clear View Development Clinical Past Accepting new patients

Locations

5104 Reagan Dr
Ste 5
Charlotte, NC 28206
Phone (704) 596-0505

999 Waterside Dr
Ste 2525
Norfolk, VA 23510
Phone (757) 777-3433

999 Waterside Dr
Ste 2600
Norfolk, VA 23510
Phone (202) 374-8819

Organizations & group practices 6

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1619920055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 SCOTCH DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541523",
            "telephone_number": "704-674-6284",
            "fax_number": "980-320-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 SCOTCH DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541523",
            "telephone_number": "704-674-6284",
            "fax_number": "980-320-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD THOMPSON",
        "first_name": "MARCIA",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003070",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2853544",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCIA",
            "last_name": "THOMPSON",
            "middle_name": "ALISON",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.