Provider Demographics
NPI:1366863961
Name:THOMPSON, BETRICE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BETRICE
Middle Name:
Last Name:THOMPSON
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 1:1075 EASTON AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1648
Mailing Address - Country:US
Mailing Address - Phone:732-309-4935
Mailing Address - Fax:732-568-0325
Practice Address - Street 1:1075 EASTON AVE STE 11
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1648
Practice Address - Country:US
Practice Address - Phone:732-309-4935
Practice Address - Fax:732-568-0325
Is Sole Proprietor?:No
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054436001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical