Individual provider Active NPI

Tyesha Thompson, MHP

  • Clinical Social Worker
  • Alexandria, LA
National Provider Identifier
1982074951
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12390 Issued in LA
Practice address
710 Versailles Blvd
Alexandria, LA 71303-2351
Phone
(318) 447-4474
NPI assigned
Oct 2, 2015
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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 12390 LA Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

710 Versailles Blvd
Alexandria, LA 71303-2351

Mailing address

601 Chester St
Apt. B
Alexandria, LA 71301-6427

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12390LAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1443744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1982074951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHESTER ST",
            "address_2": "APT. B",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713016427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 VERSAILLES BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032351",
            "telephone_number": "318-447-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "TYESHA",
        "credential": "MHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-02",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "12390",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.