Individual provider Active NPI

Rosie Lee Thompson, L.C.S.W.

  • Clinical Social Worker
  • Gary, IN
National Provider Identifier
1972822955
Registry record updated May 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34001415A Issued in IN
Practice address
6425 Birch Ave
Gary, IN 46403-1923
Phone
(219) 938-7157
Fax
(219) 938-7157
NPI assigned
May 29, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34001415A IN Primary

Addresses

Primary practice location

6425 Birch Ave
Gary, IN 46403-1923

Mailing address

PO Box 2831
6425 Birch Avenue
Gary, IN 46403-0831
Phone (219) 938-7157

Other identifiers 1

IdentifierTypeStateIssuer
100071070AMedicaidIN

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34001415AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1275091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275091200000",
    "number": "1972822955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2831",
            "address_2": "6425 BIRCH AVENUE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464030831",
            "telephone_number": "219-938-7157",
            "fax_number": "219-938-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 BIRCH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464031923",
            "telephone_number": "219-938-7157",
            "fax_number": "219-938-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "ROSIE",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-29",
        "last_updated": "2010-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34001415A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100071070A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gary, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.