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Individual
MR. VIVIAN STANFORD THOMPSON
Active
Individual
MR. VIVIAN STANFORD THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSWR
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R059610
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000370015569
HEALTH PLUS, INC.
NY
05
—
02644324
—
NY
01
—
1111003
AETNA
NY
01
—
MH00179
NYHTC HEALTH BENEFIT FUND
NY
Enumeration date
05/04/2007
Last updated
10/03/2017
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