Julius Wallace Thompson, LCSW-C

Individual provider Active NPI Clinical Social Worker · Crisfield, MD

NPI 1962444893 · NPPES record last updated Mar 5, 2008

Key facts

NPI
1962444893
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
10043 (MD)
Practice address
26740 Old State Rd
Crisfield, MD 21817-2114
Phone
(410) 651-4595
Fax
(410) 968-0191
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
10043MDMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 10043 MD Yes

Addresses

Primary practice location

26740 Old State Rd
Crisfield, MD 21817-2114

Mailing address

26740 Old State Rd
Crisfield, MD 21817-2114
Phone (410) 651-4595

Other identifiers

IdentifierTypeStateIssuer
817700700MedicaidMD

Other providers in Crisfield, MD

All providers in Crisfield, MD · Clinical Social Worker in Maryland

Sources for this page

Verify at the official NPI Registry.