Mallory Gracia-Rose Thomsen, LCSW, LMSW, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

095648 Issued in NY

Practice address

2114 Delaware Dr
Ann Arbor, MI 48103-6017

Phone

(616) 320-2021

NPI assigned

Jan 22, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mallory Sprague Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1992335673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 DELAWARE DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036017",
            "telephone_number": "616-320-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 DELAWARE DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036017",
            "telephone_number": "616-320-2021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "82 6th Ave Apt 1",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112172831",
            "country_code": "US",
            "telephone_number": "616-320-2021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMSEN",
        "first_name": "MALLORY",
        "middle_name": "GRACIA-ROSE",
        "credential": "LCSW, LMSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "095648",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801117659",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MALLORY",
            "last_name": "SPRAGUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Elizabeth Thompson, LLMSW
• Susan M Thompson, MSW, LMSW
• Taylor Thompson
• Victoria L. Thompson, DDS
• Wendy Thompson, PHD
• Thomson Solutions LLC
• Thomson Therapy Center PC
• Bruce H Thomson, LMSW
• Linda S Thomson, LMSW
• Mary J. Thomson, MD

• Clinical Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.