Provider Demographics
NPI:1174056923
Name:THOMPSON, KAREN J (LISW/LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:J
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LISW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 6019
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4124
Mailing Address - Fax:513-636-4283
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 6019
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4124
Practice Address - Fax:513-636-4283
Is Sole Proprietor?:No
Enumeration Date:2017-04-08
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 15012881041C0700X
KY40011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical