Provider Demographics
NPI:1861155608
Name:THOMPSON, ANNA MARIE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:MARIE
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3516 S 47TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-4475
Mailing Address - Country:US
Mailing Address - Phone:253-572-7888
Mailing Address - Fax:
Practice Address - Street 1:3516 S 47TH ST STE 203
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-4475
Practice Address - Country:US
Practice Address - Phone:253-572-7888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW607564311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALW60756431OtherWASHINGTON STATE DEPARTMENT OF HEALTH