Vivian Stanford Thompson, LCSWR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R059610 Issued in NY

Practice address

26 Court Street
Suite 410 D
Brooklyn, Ny, NY 11242

Phone

(646) 263-6227

NPI assigned

May 4, 2007

Last updated

Oct 3, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• A Different Journey, LLC

  • Clinical Social Worker
  • Brooklyn, NY
  • NPI 1235526443
  NPD (past) Authorized official

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506988800000",
    "number": "1629280136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 COURT ST STE 1502",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112421115",
            "telephone_number": "917-204-7852",
            "fax_number": "631-648-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 COURT STREET",
            "address_2": "SUITE 410 D",
            "city": "BROOKLYN, NY",
            "state": "NY",
            "postal_code": "11242",
            "telephone_number": "646-263-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "VIVIAN",
        "middle_name": "STANFORD",
        "name_prefix": "Mr.",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2017-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R059610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02644324",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1111003",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYHTC HEALTH BENEFIT FUND",
            "identifier": "MH00179",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS, INC.",
            "identifier": "000370015569",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yonathan Aliye Asfaw
• Tanvi Amish Dalal, MS RD CPT
• Mohamed Ali Ahmed Elsayed
• Marcus Engram, RN
• Sarah Parnes, PHYSICAL THERAPY
• Renee Claresa Wilson, LCSWR

• Clinical Social Worker in Brooklyn Ny, NY
• Providers in Brooklyn Ny, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.