Kelly Lynn Thompson, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801066239 Issued in MI

Practice address

5639 Sashabaw Rd
Clarkston, MI 48346-3149

Phone

(248) 922-9077

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Lynn Kanigowski Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

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• Elizabeth Eiten LMSW LLC

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543881600000",
    "number": "1720124308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5639 SASHABAW RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463149",
            "telephone_number": "248-922-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5639 SASHABAW RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483463149",
            "telephone_number": "248-922-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2018-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801066239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "KANIGOWSKI",
            "middle_name": "LYNN",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Bryson Thomas, DDS
• Paula Thomas
• Scott Steven Thomas, D.C.
• Theresa M Thomas, D.O.
• Chelsea Thompson
• Marilyn B Thompson, LMSW
• Shanaye L Thompson, LPN
• Tammy M Thompson, M.ED, MAC, CADC LLPC
• Tracy Eadie Thompson, MD
• Laurie Elizabeth Thomson

• All providers in Clarkston, MI
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; 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.