Provider Demographics
NPI:1962138313
Name:EMMA THOMSON LICSW LLC
Entity type:Organization
Organization Name:EMMA THOMSON LICSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-591-0890
Mailing Address - Street 1:15 SHAW ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-1817
Mailing Address - Country:US
Mailing Address - Phone:508-591-0890
Mailing Address - Fax:
Practice Address - Street 1:15 SHAW ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02191-1817
Practice Address - Country:US
Practice Address - Phone:508-591-0890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-28
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health