Provider Demographics
NPI:1144007352
Name:THOMPSON-NORMAN, ALEXANDRA L (DBH, LMSW)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:L
Last Name:THOMPSON-NORMAN
Suffix:
Gender:F
Credentials:DBH, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 RESERVOIR AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-6032
Mailing Address - Country:US
Mailing Address - Phone:401-259-0340
Mailing Address - Fax:401-213-8538
Practice Address - Street 1:1150 RESERVOIR AVE STE 203
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-6032
Practice Address - Country:US
Practice Address - Phone:401-259-0340
Practice Address - Fax:401-213-8538
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN104891041C0700X
RICSW04014101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical