Provider Demographics
NPI:1548504194
Name:THOMPSON, RHONDA J (LISW)
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:J
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:J
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW
Mailing Address - Street 1:210 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-2301
Mailing Address - Country:US
Mailing Address - Phone:641-218-4997
Mailing Address - Fax:
Practice Address - Street 1:210 S 1ST ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-2301
Practice Address - Country:US
Practice Address - Phone:641-218-4997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0069461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIA24024Medicaid