| Doctor Name: | DR. MACHELLE DENINE MADSEN THOMPSON |
| NPI Number: | 1003295759 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD, LCSW |
| License Number: | SW12492 |
| Business Practice Address: | 7188 Ox Bow Cir Tallahassee, FL - 323123569 |
| Business Phone Number: | 8505098950 |
| Business Fax Number: | |
| Mailing Address: | 7188 Ox Bow Cir, TALLAHASSEE |
| State: | FL |
| Postal Code: | 323123569 |
| Phone Number: | 8505098950 |
| Fax Number: | |
| NPI Enumeration Date: | 05/27/2015 |
| NPI Last Update Date: | 05/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | SW12492 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |