Individual
NIKITA MARIE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
917 W WALNUT ST, JOHNSON CITY, TN 37604-6527
(423) 439-6464
(423) 439-7118
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9952
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q109067
—
TN
Enumeration date
09/15/2022
Last updated
12/18/2025
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