Doctor Name: | MR. JULIUS WALLACE THOMPSON |
NPI Number: | 1962444893 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW-C |
License Number: | 10043 |
Business Practice Address: | 26740 Old State Rd Crisfield, MD - 218172114 |
Business Phone Number: | 4106514595 |
Business Fax Number: | 4109680191 |
Mailing Address: | 26740 Old State Rd, CRISFIELD |
State: | MD |
Postal Code: | 218172114 |
Phone Number: | 4106514595 |
Fax Number: | 4109680191 |
NPI Enumeration Date: | 06/12/2006 |
NPI Last Update Date: | 03/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 10043 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |