Provider Demographics
NPI:1992582589
Name:THOMPSON, ALYCIA (LMSW)
Entity type:Individual
Prefix:
First Name:ALYCIA
Middle Name:
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 1:4912 WEALDING WAY
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-4217
Mailing Address - Country:US
Mailing Address - Phone:240-412-4464
Mailing Address - Fax:
Practice Address - Street 1:4912 WEALDING WAY STE 311
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-4217
Practice Address - Country:US
Practice Address - Phone:240-412-4464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22495104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker