Provider Demographics
NPI:1619778784
Name:THOMPKINS, LORETTA (LCSW)
Entity type:Individual
Prefix:
First Name:LORETTA
Middle Name:
Last Name:THOMPKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LORETTA
Other - Middle Name:
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LORETTA THOMPKINS
Mailing Address - Street 1:3623 NW 30TH PL
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33311-8369
Mailing Address - Country:US
Mailing Address - Phone:954-866-5101
Mailing Address - Fax:
Practice Address - Street 1:3623 NW 30TH PL
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33311-8369
Practice Address - Country:US
Practice Address - Phone:954-866-5101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW243601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical