Provider Demographics
NPI:1538877188
Name:THOMPSON, HEATHER L (LCSW)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:L
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1509
Mailing Address - Country:US
Mailing Address - Phone:609-636-6440
Mailing Address - Fax:
Practice Address - Street 1:322 FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-1509
Practice Address - Country:US
Practice Address - Phone:609-636-6440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC060151001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical