Provider Demographics
NPI:1548439490
Name:THOMPSON-PARADY, JESSICA EVE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:EVE
Last Name:THOMPSON-PARADY
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 1:43 HATCH DR STE 210
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-2039
Mailing Address - Country:US
Mailing Address - Phone:207-493-3361
Mailing Address - Fax:207-492-4889
Practice Address - Street 1:675 S SHORE RD
Practice Address - Street 2:
Practice Address - City:STOCKHOLM
Practice Address - State:ME
Practice Address - Zip Code:04783-5506
Practice Address - Country:US
Practice Address - Phone:207-473-8185
Practice Address - Fax:207-492-4889
Is Sole Proprietor?:No
Enumeration Date:2008-02-25
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME126071041C0700X
MELC126071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432864299Medicaid