Provider Demographics
NPI:1104281393
Name:THOMPSON, BRYNN MILLET (LMSW)
Entity type:Individual
Prefix:MRS
First Name:BRYNN
Middle Name:MILLET
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10351 DUNDEE DR
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-7020
Mailing Address - Country:US
Mailing Address - Phone:985-507-3834
Mailing Address - Fax:225-308-4025
Practice Address - Street 1:4332 RHODA DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4136
Practice Address - Country:US
Practice Address - Phone:225-319-5586
Practice Address - Fax:225-308-4025
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12795104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker