Individual provider Active NPI

Michelle Lynn Thompson, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1912205576
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C016561 Issued in NC
Practice address
10430 Harris Oak Blvd Ste L
Charlotte, NC 28269-7513
Phone
(704) 360-3637
Fax
(704) 644-2513
NPI assigned
Mar 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 19523 MN
Clinical Social Worker 1041C0700X C016561 NC Primary

Addresses

Primary practice location

10430 Harris Oak Blvd Ste L
Charlotte, NC 28269-7513

Mailing address

2200 NW 26TH St
Owatonna, MN 55060-5503
Phone (507) 451-1120

Other practice location 1

1400 12th Ave. NW
Austin, MN 55912-2621
Phone (507) 437-9152

Other practice location 2

1400 12th Ave. NW
Austin, MN 55912-2621
Phone (507) 437-9152

Other practice location 3

2200 NW 26th St
Owatonna, MN 55060
Phone (507) 451-1120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, NC2 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
I20110523000315 MN Practitioner - Clinical Social Worker 9032395330 Reassigns benefits to 11 organizations
I20240429003331 NC Practitioner - Clinical Social Worker 9032395330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrative Wellness Solutions PLLCGroup PAC ID 8022341494, 143 clinicians

Practice addresses (Care Compare)

3625 N Elm St
Suite 130
Greensboro, NC 27455-2604
Phone (704) 360-3637

9525 Birkdale Crossing Dr
Suite 300
Huntersville, NC 28078-8459
Phone (704) 360-3637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic CurrentSince Apr 24, 2024 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Apr 24, 2024 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 1, 2017 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Apr 24, 2024 Accepting new patients
Mayo Clinic Health System-St James CurrentSince Apr 24, 2024 Accepting new patients
Mayo Clinic CurrentSince Apr 24, 2024 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Nov 1, 2017 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Apr 24, 2024 Accepting new patients
Mayo Clinic Health System-St James Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Apr 24, 2024 Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431

2200 NW 26th St
Owatonna, MN 55060
Phone (507) 451-1120

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261

501 State St N
Waseca, MN 56093
Phone (507) 835-1210

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1912205576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 NW 26TH ST",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550605503",
            "telephone_number": "507-451-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10430 HARRIS OAK BLVD STE L",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697513",
            "telephone_number": "704-360-3637",
            "fax_number": "704-644-2513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 12th Ave. NW",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "MN",
            "postal_code": "559122621",
            "country_code": "US",
            "telephone_number": "507-437-9152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 12th Ave. NW",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "MN",
            "postal_code": "559122621",
            "country_code": "US",
            "telephone_number": "507-437-9152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 NW 26th St",
            "address_purpose": "LOCATION",
            "city": "Owatonna",
            "state": "MN",
            "postal_code": "55060",
            "country_code": "US",
            "telephone_number": "507-451-1120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19523",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C016561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.