Provider Demographics
NPI:1083454235
Name:THOMPSON, JO MARIE (MSW, APSW)
Entity type:Individual
Prefix:
First Name:JO
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MSW, APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17499 KENDALL AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:WI
Mailing Address - Zip Code:54648-7115
Mailing Address - Country:US
Mailing Address - Phone:608-377-2784
Mailing Address - Fax:
Practice Address - Street 1:605 4TH ST S
Practice Address - Street 2:
Practice Address - City:LA CROSSE
Practice Address - State:WI
Practice Address - Zip Code:54601-4458
Practice Address - Country:US
Practice Address - Phone:608-377-2784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1348421211041C0700X
MN333001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical