Brenna Lynn Thompson, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4176 Issued in ND

Practice address

600 22ND Ave NW Ste 2
Minot, ND 58703-0986

Phone

(701) 818-7727

NPI assigned

Aug 20, 2018

Last updated

Aug 20, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Brenna Lynn Modin Former name

Medicare fee-for-service enrollment

Enrolled in ND

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

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crossroads Therapy PLLC

  • Clinical Social Worker
  • Minot, ND
  • NPI 1164064341
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1770063638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 7TH ST NW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587031315",
            "telephone_number": "701-720-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 22ND AVE NW STE 2",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587030986",
            "telephone_number": "701-818-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "BRENNA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ND",
            "license": "4176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENNA",
            "last_name": "MODIN",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joleen Marie Thomas, OTR
• Kati Marie Thomas
• Kayla Thomas, FNP
• Robert G Thomas, MD
• Jade Cydnei Thomaslackey
• Kaitlyn Nicole Thompson
• Shawn Michael Thompson, PA-C, MPAS
• Rae Ann Thorson
• Tiffany Thorson
• Thrivin Health, LLC

• Mental Health Counselor in Minot, ND
• Providers in Minot, ND by specialty
• Mental Health Counselor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.